TY - JOUR
T1 - Treatment options for hyperemesis gravidarum
AU - Abramowitz, Amy
AU - Miller, Emily S.
AU - Wisner, Katherine L.
N1 - Publisher Copyright:
© 2017, Springer-Verlag Wien.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Hyperemesis gravidarum (HG) is a severe and prolonged form of nausea and/or vomiting during pregnancy. HG affects 0.3–2% of pregnancies and is defined by dehydration, ketonuria, and more than 5% body weight loss. Initial pharmacologic treatment for HG includes a combination of doxylamine and pyridoxine. Additional interventions include ondansetron or dopamine antagonists such as metoclopramide or promethazine. The options are limited for women who are not adequately treated with these medications. We suggest that mirtazapine is a useful drug in this context and its efficacy has been described in case studies. Mirtazapine acts on noradrenergic, serotonergic, histaminergic, and muscarinic receptors to produce antidepressant, anxiolytic, antiemetic, sedative, and appetite-stimulating effects. Mirtazapine is not associated with an independent increased risk of birth defects. Further investigation of mirtazapine as a treatment for HG holds promise to expand treatment options for women suffering from HG.
AB - Hyperemesis gravidarum (HG) is a severe and prolonged form of nausea and/or vomiting during pregnancy. HG affects 0.3–2% of pregnancies and is defined by dehydration, ketonuria, and more than 5% body weight loss. Initial pharmacologic treatment for HG includes a combination of doxylamine and pyridoxine. Additional interventions include ondansetron or dopamine antagonists such as metoclopramide or promethazine. The options are limited for women who are not adequately treated with these medications. We suggest that mirtazapine is a useful drug in this context and its efficacy has been described in case studies. Mirtazapine acts on noradrenergic, serotonergic, histaminergic, and muscarinic receptors to produce antidepressant, anxiolytic, antiemetic, sedative, and appetite-stimulating effects. Mirtazapine is not associated with an independent increased risk of birth defects. Further investigation of mirtazapine as a treatment for HG holds promise to expand treatment options for women suffering from HG.
KW - Gastrointestinal disorders in pregnancy
KW - Hyperemesis
KW - Hyperemesis gravidarum
KW - Mirtazapine
KW - Nausea and vomiting in pregnancy
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U2 - 10.1007/s00737-016-0707-4
DO - 10.1007/s00737-016-0707-4
M3 - Review article
C2 - 28070660
AN - SCOPUS:85008624403
VL - 20
SP - 363
EP - 372
JO - Archives of Women's Mental Health
JF - Archives of Women's Mental Health
SN - 1434-1816
IS - 3
ER -