Usefulness of mirtazapine in cancer patients

Abstract

The rate of depression in the general population is estimated as high as 15% and is at least two to three times more common in patients with cancer. Due to the complexity and constraints of cancer care, depression is often under-recognised and under-treated. Antidepressants are the most commonly used medications, however among cancer patients there are few randomised trials comparing antidepressants to placebo. Mirtazapine is an effective antidepressant with unique and special mechanism of action characterised by high response and remission rates, relatively early onset of action and favourable side-effect profile. Several studies reported that mirtazapine has a receptor-binding profile that may be suitable for use in controlling appetite loss and nausea of cancer patients. We conducted a review of the literature on the use of mirtazapine in cancer patients. We evaluated the effectiveness of mirtazapine for the management of depressive and anxiety symptoms and for several distressing symptoms such as pain, nausea, appetite loss, and sleep disturbances.