University Hospitals Sussex NHS Foundation Trust, Worthing Hospital, Lyndhurst Rd, Worthing, West Sussex, BN11 2DH, UK.
Hampshire Hospitals NHS Foundation Trust, Royal Hampshire County Hospital, Romsey Rd, Winchester, Hampshire, SO22 5DG, UK.
J Med Case Rep. 2023 Apr 14;17(1):163. doi: 10.1186/s13256-023-03881-6.
Mirtazapine is a frequently prescribed psychotropic drug for depression in older age. It is considered safe and has a side-effect profile uniquely favorable to an older person affected by reduced appetite, difficulty maintaining body weight, or insomnia. However, it is largely unknown that mirtazapine can cause a dangerous decline in neutrophil count.
We present a case of mirtazapine-induced severe neutropenia in a 91-year-old white British woman requiring drug withdrawal and granulocyte-colony stimulating factor administration.
This case is of significance because mirtazapine is regarded as a safe, and often preferable, antidepressant in older age. However, this case demonstrates a rare, life-threatening side effect of mirtazapine and calls for greater pharmacovigilance when prescribing it. There is no previous report of mirtazapine-induced neutropenia requiring drug withdrawal and granulocyte-colony stimulating factor administration in an older person.
米氮平是一种常用于老年抑郁症的精神药物。它被认为是安全的，且具有独特的副作用谱，对因食欲减退、难以维持体重或失眠而受影响的老年人有益。然而，米氮平会导致中性粒细胞计数危险下降，这一点在很大程度上并不为人所知。
我们报告了一例 91 岁的白人英国女性因米氮平引起的严重中性粒细胞减少症，需要停药和粒细胞集落刺激因子治疗。
本病例意义重大，因为米氮平被认为是老年人群中一种安全且通常更优的抗抑郁药。然而，本病例表明米氮平存在罕见的、危及生命的副作用，在开处方时需要加强药物警戒。以前没有报告过米氮平引起的需要停药和粒细胞集落刺激因子治疗的老年人中性粒细胞减少症。
