Background: Mirtazapine is a noradrenergic and specific serotonergic antidepressant; its pharmacological profile indicates a low risk for dopaminergic adverse effects. To date, there has been only a single case report of Pisa syndrome associated with mirtazapine.
Case presentation: The authors report a case involving a 79-year-old woman with bipolar disorder, in whom Pisa syndrome occurred after introduction of mirtazapine, and completely disappeared 3 days after suspension of the drug.
Conclusions: Aspects of this particular case suggest that Pisa syndrome is a possible side effect of Mirtazapine.
Keywords: Bipolar disorder; Dystonia; Mirtazapine; Pisa syndrome; Side-effects.