Mirtazapine
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Mirtazapine First report of prostatism: case report
A 37-year-old man developed prostatism during treatment with mirtazapine for major depression. The man, who presented with the complaints of lack of appetite, unhappiness, insomnia and lack of energy, was diagnosed with major depression according to the Diagnostic and Statistical Manual of Mental Disorders-5 diagnostic criteria. Consequently, he was initiated on low dose paroxetine which was titrated over 2 weeks. Six weeks later, his symptoms regressed partially; however, insomnia and loss of appetite continued. Therefore, mirtazapine 15 mg/day was added [route not stated]. Six weeks following the initiation of mirtazapine, there was improvement in his depressive symptoms; however, he reported prostatism symptoms (weak urine flow and difficulty in discharge, frequent urination and urinary drip). Consequently, urology was consulted; however, there were no findings in the his urological examinations and tests (blood, urinalysis, uroflowmetry, etc.). Afterward, he was consulted to the internal medicine and nephrology. However, no aetiology of the prostatism symptoms was found. Since his prostatism symptoms started after mirtazapine initiation, it was planned to discontinue. The man’s prostatism symptoms regressed within 2 weeks of mirtazapine discontinuation. The man started mirtazapine 15 mg/d again as a self-medication, as his sleeping problems deteriorated. However, his prostatism complaints started once again, and mirtazapine was stopped. Subsequently, trazodone was added. He was continued on paroxetine. He did not have prostatism symptoms at subsequent follow-up visits. Gundogmus I, et al. Mirtazapine-Induced Prostatism. American Journal of Therapeutics : 3 Aug 2020. Available from: URL: https://journals.lww.com/americantherapeutics/ 803500136 Citation/9000/Mirtazapine_Induced_Prostatism.98229.aspx
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of prostatism associated with mirtazapine. The WHO ADR database contained no reports of prostatism associated with mirtazapine.
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Reactions 5 Sep 2020 No. 1820
