Deanna Cettomai1, Justin C McArthur. 1. Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Abstract
BACKGROUND: An efficacious treatment is needed for human immunodeficiency virus (HIV)-infected and uninfected patients with progressive multifocal leukoencephalopathy (PML). OBJECTIVE: To report clinical and magnetic resonance imaging changes in response to mirtazapine treatment in HIV-positive patients with PML. DESIGN: Case series. SETTING: Outpatient neurology clinic. PATIENTS: Four HIV-positive patients with PML. INTERVENTIONS: Mirtazapine use, 15 mg nightly. MAIN OUTCOME MEASURES: Neurologic examinations and cranial magnetic resonance imaging. RESULTS: Three patients demonstrated objective clinical improvement, and 1 patient showed improvement on magnetic resonance imaging. The patient who experienced the most significant clinical improvement was the patient who received mirtazapine therapy closest to PML symptom onset. Mirtazapine use was safe and well tolerated. CONCLUSION: Mirtazapine use may offer some benefit as treatment or prophylaxis for PML in patients with HIV infection.
BACKGROUND: An efficacious treatment is needed for human immunodeficiency virus (HIV)-infected and uninfected patients with progressive multifocal leukoencephalopathy (PML). OBJECTIVE: To report clinical and magnetic resonance imaging changes in response to mirtazapine treatment in HIV-positivepatients with PML. DESIGN: Case series. SETTING:Outpatient neurology clinic. PATIENTS: Four HIV-positivepatients with PML. INTERVENTIONS:Mirtazapine use, 15 mg nightly. MAIN OUTCOME MEASURES: Neurologic examinations and cranial magnetic resonance imaging. RESULTS: Three patients demonstrated objective clinical improvement, and 1 patient showed improvement on magnetic resonance imaging. The patient who experienced the most significant clinical improvement was the patient who received mirtazapine therapy closest to PML symptom onset. Mirtazapine use was safe and well tolerated. CONCLUSION:Mirtazapine use may offer some benefit as treatment or prophylaxis for PML in patients with HIV infection.
Authors: S Mornese Pinna; E Scarvaglieri; M G Milia; D Imperiale; V Ghisetti; S Audagnotto; A Prochet; F Lipani; S Bonora; G Di Perri; A Calcagno Journal: J Neurovirol Date: 2017-07-05 Impact factor: 2.643
Authors: Rebekka Kurmann; Christian Weisstanner; Piotr Kardas; Hans H Hirsch; Roland Wiest; Bernhard Lämmle; Hansjakob Furrer; Renaud Du Pasquier; Claudio L Bassetti; Mathias Sturzenegger; Heinz Krestel Journal: J Neurovirol Date: 2015-04-28 Impact factor: 2.643
Authors: Paola Cinque; Igor J Koralnik; Simonetta Gerevini; Jose M Miro; Richard W Price Journal: Lancet Infect Dis Date: 2009-10 Impact factor: 25.071
Authors: Thorsten Bartsch; Torge Rempe; Arne Wrede; Frank Leypoldt; Wolfgang Brück; Ortwin Adams; Axel Rohr; Olav Jansen; Christian Wüthrich; Günther Deuschl; Igor J Koralnik Journal: Ann Neurol Date: 2015-07-31 Impact factor: 10.422
Authors: Christos Vaklavas; Elsa P Sotelo-Rafiq; Jordan Lovy; Miguel A Escobar; Apostolia M Tsimberidou Journal: Virol J Date: 2010-09-28 Impact factor: 4.099