A case of discontinuation syndrome following the discontinuation of low-dose mirtazapine therapy in malignant lymphoma

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We report the case of a 69-year-old woman with malignant lymphoma who suffered from major depressive disorder. A low dose of mirtazapine (15 mg/day) brought about dramatic improvement in her mental status. However, after discontinuation of the mirtazapine, anxiety, restlessness, irritability, nausea, insomnia, imbalance and sensory disturbances occurred. When mirtazapine therapy was restarted, these symptoms resolved completely. These findings suggest that discontinuing even a low dose of mirtazapine might result in discontinuation syndrome, particularly in patients in poor physical condition. To the best of our knowledge, this is the first report describing a discontinuation syndrome due to the discontinuation of a low dose of mirtazapine.