mirtazapine as antiemetic

[miguel6565]

Searchign i readed that:
Mirtazapine is a noradrenergic and specific serotonergic antidepressant, which blocks the 5HT3 receptor, leading to an antiemetic effect

So it could be used as antiemetic in SN¿

 

[autumnal]

Searchign i readed that:
Mirtazapine is a noradrenergic and specific serotonergic antidepressant, which blocks the 5HT3 receptor, leading to an antiemetic effect

So it could be used as antiemetic in SN¿

I am not an expert, but in my opinion probably not. Mirtazapine has similar antiemetic properties to ondansetron. Neither are dopamine antagonists in the way that meto is. For the technical reasons behind this, please have a read of my existing response regarding ondanestron here. Note that following it is some technical debate on the issue between two users with a lot more medical knowledge than myself. From their discussion, it seems there are competing views on whether or not ondansetron would work as an antiemetic with SN, and it is not inconceivable that this argument could also extend to mirtazapine.

 

[Giraffey]

Anti-emetics happen to be my area of expertise, I'm not a doctor but I have a science background and I've co-written a book on nausea and vomiting, with another (more general) one due to be published later in the year (hopefully before I CTB, the publisher will withhold royalties otherwise). I wouldn't want to weigh in specifically on SN without doing some research though as it's not a method I'm overly familiar with. At a cursory glance, I agree with autumnal's assessment.

I'm also hesitant to repeat much of the discussion in the threat autumnal linked to, the technical discussion can become very confusing, very quickly - and even among experts, there is sometimes disagreement as to the effectiveness of one medication over another.

Metoclopramide is generally considered the best anti-emetic for the job (for reasons discussed above) and perhaps, more importantly, it is tried and tested. I and others could easily suggest alternatives and different combinations that may theoretically have the same effect, but with that, you introduce the risk of uncertainty. If I were in your shoes then I would need to find an alternative as I'm one of the minority who suffers extrapyramidal side-effects from Metoclopramide even at a fairly low dose, but if you have no such trouble it's worth the effort of sourcing, or using an alternative dopamine D2 antagonist (domperidone may be a good fit as it also has some prokinetic properties).

Edit: Corrected a couple of typos.