Mirtazapine使用於因糖尿病引起胃輕癱伴隨嚴重噁心和嘔吐而導致重度憂鬱症的治療

Mirtazapine for Major Depressive Disorder with Severe Nausea and Vomiting Secondary to Diabetic Gastroparesis

目的：我們提出一位糖尿病因胃輕癱伴隨嚴重噁心和嘔吐而導致重度憂鬱症的個案。病例報告：一位38 歲女性病人因胃輕癱伴隨嚴重噁心和嘔吐，而導致重度憂鬱症對於prokinetic agents 的反應不佳，因此併用mirtazapine 和prokinetic agents，在合併治療後個案的 情況如憂鬱，噁心／嘔吐獲得改善。之後病人在門診持續接受追蹤，並服用mirtazapine 作 為維持療法。在門診追蹤期間，病人的重鬱症並無復發，且也沒有再出現胃輕癱，導致嚴重 噁心和嘔吐的情況。結論：本案例經驗顯示mirtazapine 可以有效治療和預防因胃輕癱，導 致嚴重噁心和嘔吐而引起的反覆性憂鬱復發。

Objective: We report a case of a patient with major depressive disorder caused by diabetic gastroparesis-related severe nausea and vomiting. Case Report: The patient responded poorly to prokinetic agents, but her symptoms, such as depression, nausea/vomiting, were improved after the prokinetic agents were combined with mirtazapine. She was discharged in a stable condition and kept receiving mirtazapine. She did not show any recurrent depression, and diabetic gastroparesisrelated severe nausea and vomiting during follow-up. Conclusion: This is the fi rst case report to show that mirtazapine may be effective for treating and preventing recurrent depression caused by diabetic gastroparesis-related severe nausea and vomiting.