Mirtazapine (Remergil) for treatment resistant hyperemesis gravidarum: rescue of a twin pregnancy

Abstract

Case report: We present the case of a 25-year-old woman with treatment resistant hyperemesis gravidarum in the 15th week with a 13 kg loss of body weight. When the patient asked for termination of the pregnancy because of the unbearable symptoms, treatment with intravenous mirtazapine (Remergil) was started.

Results: Nausea and vomiting disappeared within hours, pregnancy termination was no longer desired. The patient was discharged two weeks later in good health and at 36 weeks gestation a cesarean section was performed. Post partum evaluation as well as 6-month post-partum revealed no dysmorphology or laboratory abnormalities in the children.