A review of therapeutic uses of mirtazapine in psychiatric and medical conditions.

OBJECTIVE To review the literature examining the use of mirtazapine with an emphasis on its therapeutic benefits for psychiatric patients with comorbid medical conditions. DATA SOURCES MEDLINE, PsycINFO, Global Health, and AGRICOLA were searched using the terms mirtazapine OR Remeron. Limits were English language, human, year 1980-2012, treatment and prevention, and therapy. STUDY SELECTION Two hundred ninety-three articles were identified. DATA EXTRACTION Identified articles were reviewed with a focus on indications and therapeutic benefits in patients with medical comorbidities. RESULTS Mirtazapine is an effective antidepressant with unique mechanisms of action. It is characterized by a relatively rapid onset of action, high response and remission rates, a favorable side-effect profile, and several unique therapeutic benefits over other antidepressants. Mirtazapine has also shown promise in treating some medical disorders, including neurologic conditions, and ameliorating some of the associated debilitating symptoms of weight loss, insomnia, and postoperative nausea and vomiting. CONCLUSIONS Mirtazapine offers clinicians multiple therapeutic advantages especially when treating patients with comorbid medical illness.