Effect of Mirtazapine for the Prevention of Nausea and Vomiting in Patients With Thoracic Cancer Receiving Platinum-based Chemotherapy

Pharmacological update of mirtazapine: a narrative literature review

“…MTZ decreased the levels of protein kinase C, TGF-β1, phosphorylated Smad3, p-ERK1/2 MTZ significantly reduced oxidative stress, by declining hepatic lipid peroxidation and NADPH oxidase 1 and increased GSH content El-Tanbouly et al ( 2017 ) Kidney diseases Diabetic nephropathy in rats MTZ downregulated NLRP3 and caspase-1 expression as well as the renal level of IL-1β in diabetic rats MTZ may be effective in the management of DM and other metabolic illnesses Sahin et al ( 2019 ) Cardiovascular diseases related to CNS disorders An in vitro human plasma-based study The antiplatelet effects MTZ are mediated by 5-HT2A and α2-adrenergic receptors blocking Kawano et al ( 2022 ) Diabetes Type 1 diabetic rats In T1DM rat models, MTZ reduced GLUT2 by changing the expression of leptin and galanin in the livers of type 1 diabetic rats with hyperglycaemia. These findings concluded that patients with T1DM can use MTZ as an antidepressant and as a medication to lower blood glucose levels Bektur et al ( 2019a ) Diabetes-induced hyperalgesia in rats MTZ exhibits beneficial effects in diabetes-induced hyperalgesia is mediated by decreasing TRPV1 and ASIC1 levels Bektur et al ( 2019b ) GIT Nausea and vomiting in chemotherapy-treated cancer patients In a study of 35 patients, when given in conjunction with platinum-based regimens to patients with thoracic cancer, adding MTZ to the recommended antiemetic regimen for CINV may be advantageous with appropriate tolerability Kinomura et al ( 2023 ) Heavy metal-induced neurotoxicity Cd-induced neurotoxicity in rats MTZ attenuates Cd-induced neurotoxicity by upregulating the transcription factor Nrf2, suppressing NF-κB/TLR4 signalling, MTZ effectively decreasing TNF-α, IL-1β, and IL-6 MTZ reduced histological abrasions in the dentate gyrus, CA1 and CA3 regions of the hippocampus, and cerebral cortex of the rat brain Alharthy et al ( 2023 ) Reproductive diseases CP-induced oxidative stress in rat ovaries CP-induced oxidative stress in rat ovaries causes infertility in female rats. MTZ could counteract this impact and ...…”

Mirtazapine as Appetite Stimulant in Patients With Non–Small Cell Lung Cancer and Anorexia

“…Mirtazapine is a promising agent that antagonizes at central presynaptic α 2 autoreceptors, postsynaptic 5HT 2 /5HT 3 , and H 1 receptors . This favors an antidepressant effect and owing to its antagonism on 5HT 2 /5HT 3 receptors could exert an analgesic and antiemetic effect . In addition, it could stimulate the appetite and increase body weight .…”

“…12 This favors an antidepressant effect and owing to its antagonism on 5HT 2 /5HT 3 receptors could exert an analgesic and antiemetic effect. 12,13 In addition, it could stimulate the appetite and increase body weight. 12 As such, mirtazapine has recently been proposed as an encouraging option in this context based on its appetite stimulant properties, through regulatory effects in the central nervous system and gastric motility.…”

A study on the efficacy and safety of aprepitant injection in preventing and treating nausea and vomiting induced by platinum‐based chemotherapy in lung cancer

“…Conventional treatment methods include surgery, radiation therapy, and chemotherapy. Platinum containing dual drug chemotherapy is the main first‐line chemotherapy for advanced lung cancer, but it can cause chemotherapy‐induced nausea and vomiting (CINV) and other adverse reactions, seriously affecting the quality of life of patients 2 . According to statistics, the lack of sufficient antiemetic treatment can lead to nausea and vomiting symptoms in over 90% of patients who use cisplatin and area under curve (AUC) ≥4 carboplatin 3 and may even cause patients to interrupt treatment or delay the treatment process.…”