Mirtazapine in essential tremor: a double-blind, placebo-controlled pilot study.
Identifieur interne : 000A65 ( Ncbi/Curation ); précédent : 000A64; suivant : 000A66Mirtazapine in essential tremor: a double-blind, placebo-controlled pilot study.
Auteurs : Rajesh Pahwa [États-Unis] ; Kelly E. LyonsSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Aged, Antidepressive Agents, Tricyclic (administration & dosage), Antidepressive Agents, Tricyclic (pharmacology), Antidepressive Agents, Tricyclic (therapeutic use), Cross-Over Studies, Double-Blind Method, Essential Tremor (diagnosis), Essential Tremor (drug therapy), Female, Humans, Male, Mianserin (administration & dosage), Mianserin (analogs & derivatives), Mianserin (pharmacology), Mianserin (therapeutic use), Outcome Assessment (Health Care), Psychomotor Performance (drug effects), Questionnaires, Severity of Illness Index.
- MESH :
- chemical , administration & dosage : Antidepressive Agents, Tricyclic, Mianserin.
- chemical , analogs & derivatives : Mianserin.
- chemical , pharmacology : Antidepressive Agents, Tricyclic, Mianserin.
- chemical , therapeutic use : Antidepressive Agents, Tricyclic, Mianserin.
- diagnosis : Essential Tremor.
- drug effects : Psychomotor Performance.
- drug therapy : Essential Tremor.
- Aged, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Outcome Assessment (Health Care), Questionnaires, Severity of Illness Index.
Abstract
We sought to determine whether mirtazapine is safe and well-tolerated as a treatment for essential tremor (ET). We studied mirtazapine in a randomized, double-blind, placebo-controlled, crossover study of 17 ET patients. Patients were started with 15 mg per day of either mirtazapine or placebo for 1 week and the dose was escalated weekly until the targeted dose of 45 mg per day was achieved. This dose was maintained for 2 weeks. Tremor was assessed at baseline and after 14 days of 45 mg of mirtazapine or placebo. There was a minimum washout period of 14 days between the two arms of the study. Tremor assessments included global improvement, Fahn Tolosa Marin Tremor Rating Scale, Beck Depression Inventory and the Parkinson's Disease Questionnaire-39. Patient global improvement ratings indicated that in the placebo condition 12 patients were unchanged and 1 patient was mildly improved. In the mirtazapine condition, 10 patients were unchanged, 2 were moderately improved and 1 was markedly improved. There was no significant improvement with mirtazapine or placebo compared to baseline as measured by the Tremor Rating Scale. Adverse effects were more common in the mirtazapine group and included drowsiness, confusion, dry mouth, weight gain, polyuria, itching, nausea, gait and balance problems, blurred vision, and bad taste. We conclude that the majority of the ET patients do not benefit from mirtazapine. Mirtazapine has significant adverse effects and should be used cautiously in ET patients.
DOI: 10.1002/mds.10371
PubMed: 12722174
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<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA. rpahwa@kumc.edu</nlm:affiliation>
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<front><div type="abstract" xml:lang="en">We sought to determine whether mirtazapine is safe and well-tolerated as a treatment for essential tremor (ET). We studied mirtazapine in a randomized, double-blind, placebo-controlled, crossover study of 17 ET patients. Patients were started with 15 mg per day of either mirtazapine or placebo for 1 week and the dose was escalated weekly until the targeted dose of 45 mg per day was achieved. This dose was maintained for 2 weeks. Tremor was assessed at baseline and after 14 days of 45 mg of mirtazapine or placebo. There was a minimum washout period of 14 days between the two arms of the study. Tremor assessments included global improvement, Fahn Tolosa Marin Tremor Rating Scale, Beck Depression Inventory and the Parkinson's Disease Questionnaire-39. Patient global improvement ratings indicated that in the placebo condition 12 patients were unchanged and 1 patient was mildly improved. In the mirtazapine condition, 10 patients were unchanged, 2 were moderately improved and 1 was markedly improved. There was no significant improvement with mirtazapine or placebo compared to baseline as measured by the Tremor Rating Scale. Adverse effects were more common in the mirtazapine group and included drowsiness, confusion, dry mouth, weight gain, polyuria, itching, nausea, gait and balance problems, blurred vision, and bad taste. We conclude that the majority of the ET patients do not benefit from mirtazapine. Mirtazapine has significant adverse effects and should be used cautiously in ET patients.</div>
</front>
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