Mirtazapine in the treatment of adolescent anorexia nervosa. Case-control study

Anorexia nervosa (AN) is a serious and potentially life-threatening psychiatric disorder. Pharmacotherapeutic possibilities still remain limited. We sought to determine if there was a positive effect on body weight and body mass index (BMI) in AN patients being treated for depression or anxiety with mirtazapine.

Using a case-control design, we found nine female patients with AN who had been treated with mirtazapine for depression or anxiety during hospitalization in our department. We also found nine female controls with AN, who had not received any pharmacotherapy. The two groups of patients were matched according to age and BMI. Case and control groups did not differ significantly in age (15.2 +/- 1.9 Vs. 14.7 +/- 1.7 years; P = 0.549), or in BMI (15.6 +/- 2.3 Vs. 15.6 +/- 2.1; P = 0.946) at baseline. Weight and BMI were evaluated at baseline and again after the patients had completed 1, 2, 3 and 4 weeks of treatment.

The mean dose of mirtazapine was 21.7 +/- 1.8 mg at the end of week 4. Using ANOVA Repeated Measures, we found no significant differences between cases and controls with regard to weight (P = 0.981) or BMI (P = 0.576). However, there was a non-significant trend in patients which had been treated with mirtazapine which showed slightly more improvement, in the measured parameters, at the end of weeks 1, 2 and 3, compared to controls.

Results are limited by small sample size. However, the use of mirtazapine could be useful in the treatment of AN in adolescence.