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Accepted: 24 January 2022 / Published online: 21 February 2022
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022
Abstract
Objective The objective of this study was to assess the clinical response and safety of mirtazapine in the pediatric population with a diagnosis of functional nausea and nausea associated with functional dyspepsia postprandial distress syndrome.
Methods This was a retrospective chart review to evaluate the safety and efficacy of mirtazapine for pediatric nausea and nausea associated with functional dyspepsia postprandial distress syndrome. Clinical response was classified as complete response, partial response, and no response. We also identified the prescribed doses, side effects, and weight changes during mirtazapine therapy.
Results Among the 57 total patients, 67% were females and ages ranged from 7 to 19 years with a mean of 14 ± 3 years. Clinical (complete and partial) response was reported in 82% of patients. Nausea resolved in 82% and insomnia in 77% of the patients. Eighty-four percent gained weight with a mean of 4 ± 7 kg. Sixty-five percent did not report adverse effects. The most common adverse effects were undesired weight gain (16%) and dysphoria (9%). Two patients discontinued the medicine after the first dose because of adverse effects. There was a significant correlation between the initial dose and weight (rs = 0.478; p = 0.0002). The median initial and final doses were 15 mg, respectively.
Conclusions Mirtazapine is an option for treating children and adolescents with functional nausea and nausea associated with functional dyspepsia post-prandial distress syndrome, especially for a select group of patients with concurrent weight loss, anxiety, and insomnia.
1Introduction
Nausea is a dysphoric sensation in the upper abdomen associated with salivation, anorexia, and often followed by vomiting. Two commonly associated conditions for chronic nausea include functional dyspepsia (FD) and functional nausea (FN). The Rome IV diagnostic criteria for FD consists of one or more of the following symptoms for at least 4 days per month for at least 2 months: postprandial fullness, early satiation, and epigastric pain without evidence of organic disease. There are two phenotypes of FD, epigastric pain, and postprandial distress syndrome (FD-PDS). Nausea can be a component of FD-PDS, but it is not associated with the epigastric pain form of FD. FD-PDS is...