Rapid response to mirtazapine in cyclic vomiting syndrome refractory to conventional prokinetics

摘要

TO THE EDITOR: Cyclic vomiting syndrome (CVS) is denned as a dramatic syndrome characterized by intense episodes of nausea and vomiting lasting over days, with alternating periods of quiescence. Although this disorder was initially described in children, recently it has been increasingly recognized in adults.The pathogenesis of CVS has yet to be established, and there is no known treatment of choice for CVS until now, especially in adult patients. The trial cases of tricyclic antidepressants, mirtazapine, cloni-dine, and sumatriptan, were reported for some patients with CVS, but most of them were cases of children or adolescents who had comorbid depressive or anxiety disorders. This report describes an adult patient who suffered from severe recurrent nausea and vomiting without depression or anxiety symptoms and rapidly responded to mirtazapine.