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Effect of Mirtazapine on Nausea in Children with Functional Nausea and Functional Dyspepsia Postprandial Distress
Ivonne M Iglesias-Escabi1,2, David Kleesattel3, Lee S McDaniel4
1Department of Pediatric Gastroenterology, Hepatology, and Nutrition of LSU Health Sciences Center New Orleans, New Orleans, LA, USA.
Insights
Mirtazapine effectively treated pediatric functional nausea and functional dyspepsia postprandial distress syndrome in 82% of patients, resolving nausea and insomnia. This medication is a viable option, particularly for children experiencing weight loss, anxiety, and insomnia.
Area of Science:
- Pediatric Gastroenterology
- Pharmacology
- Clinical Therapeutics
Background:
- Functional nausea and functional dyspepsia postprandial distress syndrome significantly impact children's quality of life.
- Limited therapeutic options exist for managing these conditions in pediatric patients.
Purpose of the Study:
- To evaluate the clinical response and safety of mirtazapine in pediatric patients diagnosed with functional nausea.
- To assess mirtazapine's efficacy in treating nausea associated with functional dyspepsia postprandial distress syndrome in children.
Main Methods:
- A retrospective chart review was conducted to analyze patient data.
- Clinical response was categorized as complete, partial, or no response.
- Prescribed doses, side effects, and weight changes were systematically recorded.
Main Results:
- Mirtazapine showed an 82% clinical response rate, resolving nausea in 82% and insomnia in 77% of pediatric patients.
- Eighty-four percent of patients experienced weight gain, with a mean increase of 4 kg.
- Adverse effects were infrequent, with undesired weight gain (16%) and dysphoria (9%) being most common.
Conclusions:
- Mirtazapine is a promising treatment option for pediatric functional nausea and functional dyspepsia postprandial distress syndrome.
- The medication is particularly beneficial for children with co-occurring weight loss, anxiety, and insomnia.
- Mirtazapine demonstrates a favorable safety profile in the pediatric population for these indications.
Objective:
The objective of this study was to assess the clinical response and safety of mirtazapine in the pediatric population with a diagnosis of functional nausea and nausea associated with functional dyspepsia postprandial distress syndrome.
Methods:
This was a retrospective chart review to evaluate the safety and efficacy of mirtazapine for pediatric nausea and nausea associated with functional dyspepsia postprandial distress syndrome. Clinical response was classified as complete response, partial response, and no response. We also identified the prescribed doses, side effects, and weight changes during mirtazapine therapy.
Results:
Among the 57 total patients, 67% were females and ages ranged from 7 to 19 years with a mean of 14 ± 3 years. Clinical (complete and partial) response was reported in 82% of patients. Nausea resolved in 82% and insomnia in 77% of the patients. Eighty-four percent gained weight with a mean of 4 ± 7 kg. Sixty-five percent did not report adverse effects. The most common adverse effects were undesired weight gain (16%) and dysphoria (9%). Two patients discontinued the medicine after the first dose because of adverse effects. There was a significant correlation between the initial dose and weight (rs = 0.478; p = 0.0002). The median initial and final doses were 15 mg, respectively.
Conclusions:
Mirtazapine is an option for treating children and adolescents with functional nausea and nausea associated with functional dyspepsia post-prandial distress syndrome, especially for a select group of patients with concurrent weight loss, anxiety, and insomnia.
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