Table 1.

Summary of studies examining the effects of mirtazpine in treating chronic pruritus. * Determined based on the Oxford Centre for Evidence-based Medicine (CEBM) Levels of Evidence. Mirtazapine; CS, case series; CR, case report.

Grade of Recommendation *	Study Design	Diagnosis	N	Regimen	Degree of Pruritus Reduction	Reference
C	CS	Atopic dermatitis	2	15 mg mirtazapine every day for three months (first patient) and six months (second patient).	Both patients noted a “significant reduction” of nocturnal and daytime pruritus and improvement in sleep.	[7]
		Lichen simplex chronicus	1	15 mg mirtazapine every day for two months.	Patient noted a complete resolution of nocturnal pruritus and “significant reduction” in daytime pruritus.
C	CS	Adenocarcinoma of unknown origin	4	15 mg mirtazapine every night until death.	The patient reported complete resolution of pruritus within 24 hours.	[2]
		Nodular sclerosis Hodgkin’s disease		15 mg mirtazapine every night. After an unspecified length of time, the dosage was increased to 30 mg every night until death.	The patient reported 75% improvement in pruritic symptoms on 15 mg mirtazapine and complete resolution of itch on 30 mg mirtazapine.
		Large B-cell lymphoma		15 mg mirtazapine every night. After an unspecified length of time, the dosage was increased to 30 mg every night and continued for an unspecified length of time.	The patient reported 80% improvement in pruritic symptoms on 15 mg mirtazapine and complete resolution of itch on 30 mg mirtazapine.
		Advanced renal cell carcinoma		15 mg mirtazapine every night. One month later, dosage was increased to 30 mg and maintained at that level until death.	The patient reported complete resolution of pruritus on 30 mg mirtazapine.
C	CR	Carcinoma en cuirasse	1	15 mg oral mirtazapine every night for an unspecified duration.	The patient reported a decrease in itch intensity from “200/100” pre-treatment to 2/100 twelve hours after starting mirtazapine.	[6]