Mirtazapine is a novel antidepressant with a pharmacologic profile (α-2 antagonist, 5HT-1A, agonist, and 5HT-2 antagonist) that renders it potentially useful for L-dopa-induced dyskinesias. Drugs with 5HT-1A agonistic activity, such as buspirone and tandospirone, have been reported to be effective in reducing L-dopa-induced dyskinesias. Furthermore, 5HT-2 antagonism may, by reducing substantia nigra pars reticulata hyperactivity, play a role in the improvement of Parkinsonian symptoms and L-dopa-induced dyskinesias, as has been observed with ritanserin, a 5HT-2 antagonist. Alpha-2 antagonists, such as idazoxan, have recently also been reported to improve L-dopa-induced dyskinesias. The authors investigated the antidyskinetic properties of mirtazapine by designing an open-label study of 20 Parkinsonian patients with L-dopa-induced dyskinesias. Mirtazapine proved to be moderately effective in reducing L-dopa-induced dyskinesias, either alone or in association with amantadine. Mirtazapine may be of use in patients who do not respond or are intolerant to amantadine.
- Parkinson disease
ASJC Scopus subject areas
- Pharmacology (medical)
- Clinical Neurology
- Pharmacology, Toxicology and Pharmaceutics(all)