Mirtazapine
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Mirtazapine Restless legs syndrome: 14 case reports Six men and eight women, aged 43–80 years, developed restless legs syndrome (RLS) after starting mirtazapine for psychiatric disorders [dosages not stated]. The cases were identified during a retrospective review of medical records. Four patients experienced an exacerbation of RLS and ten developed de novo RLS [see table]. Onset of RLS occurred on the first day of treatment in nine patients, within 3 days in three patients and 10 days and 3 months after commencing mirtazapine in the remaining two patients.
Patient characteristics Patient/sex/ age (y) 1/F/63 2/M/45 3/F/43 4/M/59 5/F/65 6/F/71 7/F/58 8/F/58 9/F/55 10/F/67 11/M/80 12/M/65 13/M/71 14/M/61
Time to onset (d)
Nature of RLS
1 1 1 1 1 1 1 1 1 3 3 3 10 90
Exacerbation Exacerbation Exacerbation Exacerbation De novo De novo De novo De novo De novo De novo De novo De novo De novo De novo
Mirtazapine was discontinued in 12 patients, resulting in immediate symptomatic improvement. Patients 4 and 5 also experienced symptomatic improvement after the addition of gabapentin and ropinirole, respectively. Twelve patients were receiving concomitant tramadol, nonopioid analgesics, antihistamines or dopamine antagonists; patients 8 and 11 did not receive any of these medications while receiving mirtazapine. Patients 1, 2 and 6 experienced a RLS relapse several months after discontinuing mirtazapine; all three were receiving antidepressants at the time. Kim S-W, et al. Factors potentiating the risk of mirtazapine-associated restless legs syndrome. Human Psychopharmacology: Clinical and Experimental 23: 615-620, 801128496 No. 7, Oct 2008 - South Korea
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Reactions 22 Nov 2008 No. 1229
