Article type: Review Article
Article
title: Mirtazapine-associated
movement disorders: a literature review
Journal: Tzu Chi Medical Journal
Year: 2020
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Mirtazapine (MTZ) is an atypical antidepressant
approved by the FDA, which mechanism of action involves the antagonism of
alpha-2, H1, 5-HT2A, 5-HT2C, and 5-HT3 receptors. In this context, the aim of
this literature review is to evaluate the clinical epidemiological profile,
pathological mechanisms, and management of MTZ-associated movement disorders
(MDs). Relevant reports of six databases were identified and assessed by two
reviewers without language restriction. Fifty-two reports containing 179 cases
from 20 countries were assessed. The mean age was 57 year (range, 17–85). The
majority of the individuals were female (60%) and of European origin. The mean
time from MTZ start to symptom onset was 7.54 days; the time from management to
MD improvement was within one week in 82.60% of the individuals. The MDs
associated with MTZ were 69 restless legs syndrome (RLS), 35 tremors, 10
akathisia (AKT), 9 periodic limb MD, 6 dystonia, 4 rapid eye movement sleep
behavior disorders, 3 dyskinesia, 2 parkinsonism, and 1 tic, and in the group
not clearly identified, 18 restlessness, 15 hyperkinesis, and 1 extrapyramidal
symptom. In the literature, the majority of the reports lack important
information about the neurological examination. The management should be the
MTZ withdrawal, except in RLS that other options are possible. In AKT, the MTZ
should not be rechallenge, and if available, the prescription of a
benzodiazepine may reduce recovery time.
Key-words: Drug-induced, mirtazapine, movement
disorder, org 3770, review
Full
text available at:
DOI
10.4103/tcmj.tcmj_13_20
Citation
Rissardo
JP, Caprara AL. Mirtazapine-associated
movement disorders: a literature review. Tzu Chi Med J 2020;32:318-30
