Rapid efficacy of mirtazapine in the treatment of hyperemesis gravidarum with esophagus perforation and ketonuria in a normoglycemic patient: A case report

Abstract

Hyperemesis gravidarum is a medical condition that may cause serious consequences for fetus and mother. The treatment regimen in patients with severe and treatment-resistant conditions is unclear. While antiemetics are known to be used for hyperemesis gravidarum in the literature, mirtazapine has been used effectively in some treatment-resistant cases. On the other hand, to the best of our knowledge, no reports on the efficacy of mirtazapine in cases of severe and treatment-resistant hyperemesis gravidarum have been published in the literature. The aim of our report was to present a successful treatment with mirtazapine for a 28-year-old pregnant patient who developed esophageal perforation and ketonuria while being normoglycemic due to severe and treatment-resistant hyperemesis gravidarum. This case revealed that mirtazapine may be effective even in severe cases of hyperemesis gravidarum. In addition, the effectiveness of mirtazapine in the treatment of hyperemesis gravidarum has been confirmed. However, the appropriateness of using mirtazapine in the treatment of pregnant patients needs to be discussed.