Abstract
BackgroundMirtazapine is a noradrenergic and specific serotonergic antidepressant; its pharmacological profile indicates a low risk for dopaminergic adverse effects. To date, there has been only a single case report of Pisa syndrome associated with mirtazapine.Case presentationThe authors report a case involving a 79-year-old woman with bipolar disorder, in whom Pisa syndrome occurred after introduction of mirtazapine, and completely disappeared 3 days after suspension of the drug.ConclusionsAspects of this particular case suggest that Pisa syndrome is a possible side effect of Mirtazapine.
Highlights
Mirtazapine is a noradrenergic and specific serotonergic antidepressant; its pharmacological profile indicates a low risk for dopaminergic adverse effects
In the three clinical trials undertaken in Japan, the incidence of dyskinesia was 0–1.0% but there was no report in terms of parkinsonism or dystonia [2]
The present report describes a case of Pisa syndrome that manifested after administration of MTZ to a patient previously diagnosed with bipolar disorder
Summary
Mirtazapine is a noradrenergic and specific serotonergic antidepressant; its pharmacological profile indicates a low risk for dopaminergic adverse effects. Because MTZ does not strongly block the dopamine D1/D2 receptor, there are few reports describing parkinsonism caused by the drug. In the English literature, there are only two case reports describing dystonia with MTZ use, with one involving Pisa syndrome [3, 4], both of which are cases of major depression. Drug-induced Pisa syndrome is commonly observed in patients undergoing long-term antipsychotic treatment.
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