Related Experiment Video
Updated: Mar 29, 2026
05:10
Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
1.4K
Mirtazapine-Associated Hypertriglyceridemia and Hyperglycemia
Nakia A Duncan1, Kalin M Clifford, Olga M Shvarts
1Division of Geriatrics, Texas Tech University Health Sciences Center (TTUHSC) School of Pharmacy-Dallas Campus, Dallas, Texas, USA.
Summary
Mirtazapine treatment in an elderly patient with dementia led to severe hypertriglyceridemia and hyperglycemia, mimicking diabetes mellitus. These metabolic disturbances persisted even after discontinuing the medication.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Endocrinology
Background:
- A 75-year-old male patient with advancing dementia was prescribed mirtazapine for mood and appetite.
- Mirtazapine is a medication commonly used in elderly patients for depression and appetite stimulation.
Observation:
- The patient developed severe hypertriglyceridemia (high triglyceride levels).
- This was followed by hyperglycemia (high blood sugar), presenting symptoms similar to diabetes mellitus.
Findings:
- The patient required insulin therapy to manage the hyperglycemia.
- Elevated triglyceride levels persisted even after mirtazapine was discontinued.
Implications:
- This case highlights a potential adverse metabolic effect of mirtazapine, specifically severe hypertriglyceridemia and hyperglycemia.
- Clinicians should monitor lipid and glucose levels in patients treated with mirtazapine, especially the elderly.
- The persistent nature of these metabolic abnormalities warrants further investigation into the long-term effects of mirtazapine.
More Related Videos
Related Concept Videos
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
929
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
929
01:23Antidepressant Drugs: MAOIs and Other Agents
1.2K
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
1.2K
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
859
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
859
01:23Dipeptidyl Peptidase 4 Inhibitors
1.0K
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
1.0K
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
1.8K
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
1.8K
01:06Oral Hypoglycemic Agents: Glinides
936
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
936