Mirtazapine Boosts Energy Intake in Patients with Cancer-related Anorexia: JAMA

A recent clinical trial explored the potential of Mirtazapine, which is commonly used for depression to combat cancer-related anorexia. Anorexia often poses a significant challenge in the treatment of advanced non-small cell lung cancer (NSCLC) by impacting the survival of the patients. The key findings of the study were published in the Journal of American Medical Association.

This randomized, double-blind, placebo-controlled trial was conducted from August 2018 to May 2022 and involved 86 eligible patients. Each group had 43 patients who received Mirtazapine and placebo. The participants who were of 63.5 years in average were closely monitored for 8 weeks.

While there was no significant difference in appetite scores between the Mirtazapine and placebo groups, the outcomes revealed a concerning energy intake. After 4 weeks, the Mirtazapine group exhibited a substantial increase in energy consumption, including proteins, carbohydrates and fats. The intake of fats were particularly higher in patients on Mirtazapine.

The Mirtazapine-treated patients experienced a significant reduction in the proportion of individuals with sarcopenia at the 8-week mark. The addition of Mirtazapine to the treatment regimen showed its potential to help patients meet their energy requirements and enhance health-related quality of life.

Despite the patients on Mirtazapine reported a higher perception of nightmares at the 2-week mark, this effect was found to be nonsignificant after 4 and 8 weeks. The participants in the Mirtazapine group tolerated the treatment well. The findings of this trial suggest that Mirtazapine could play a pivotal role in improving the overall well-being of patients with advanced NSCLC and anorexia. 

Reference:

Arrieta, O., Cárdenas-Fernández, D., Rodriguez-Mayoral, O., Gutierrez-Torres, S., Castañares, D., Flores-Estrada, D., Reyes, E., López, D., Barragán, P., Soberanis Pina, P., Cardona, A. F., & Turcott, J. G. (2024). Mirtazapine as Appetite Stimulant in Patients With Non–Small Cell Lung Cancer and Anorexia. In JAMA Oncology. American Medical Association (AMA). https://doi.org/10.1001/jamaoncol.2023.5232