Hypotension, the infl uence of mirtazapine in a patient with chronic renal failure

Abstract

In patients with end-stage renal disease (ESRD), depression is the most commonly identifi ed psychiatric illness; however, its prevalence varies since it is assessed by using different methods in different studies and in different populations. The commonly accepted view in the treatment of depression is a combination of psychotherapy and pharmacologic treatment. Mirtazapine is an antidepressant used in the treatment of major depressive illness which affects both noradrenergic and serotonergic activity. This paper is a case report of a 40 year old man with a history of renal failure who developed hypotension while receiving mirtazapine therapy. We believe that hypotension was a conclusion of the mirtazapine in our patient and hemodialysis had no infl uence on hypotension. Hypotension improved after the metabolization of mirtazapine (approximately thirty-six hours).