An Alternative Therapeutic Approach For Hyperemesis Gravidarum That is Unresponsive to Conventional Treatment: Mirtazapine

Abstract

Abstract Objective: To evaluate the efficacy of mirtazapine using the PUQE score in the treatment of resistant hyperemesis in pregnant women diagnosed with hyperemesis gravidarum who did not respond to standard treatment protocols. Conventional treatments often fall short in providing relief for a subset of patients, necessitating exploration of alternative therapeutic approaches. Methods; A total of 100 pregnant women, comprising 50 treated with mirtazapine (Group 2) and 50 receiving conventional antiemetics (Group 1), were analyzed. Results demonstrated a notable reduction in Pregnancy-Unique Quantification of Emesis (PUQE) scores in the mirtazapine group compared to the conventional treatment group. Results; The PUQE score, which was first evaluated before the medication, was higher in the HG with mirtazapine group (p = 0.003). Compared to the HG with other drugs group, the PUQE score on post-drug day 1 was lower in the HG with mirtazapine group (p = 0.001, respectively). Compared to HG with other drugs group, PUQE score was lower in HG with the mirtazapine group on post-drug day 3 (p =0.001, respectively). Compared to the HG with other drugs group, the PUQE score on the 7th post-drug day was lower in the HG with mirtazapine group (p =0.001, respectively). Conclusion; This study showed that mirtazapine was effective in cases of hyperemesis gravidarum that did not respond to increasing treatment. Randomized, controlled, prospective trials are necessary to ascertain the safety of the medicine and investigate the enduring consequences of mirtazapine consumption. What does this study add to the clinical work Mirtazapine can be regarded as a reliable and efficient intervention for mitigating adverse maternal and perinatal consequences in patients experiencing intractable nausea and vomiting. This therapy option is particularly suitable for individuals who have not responded to alternative therapies, have severely restricted oral intake, and have experienced substantial weight loss.