Peripheral edema associated with olanzapine-mirtazapine combination: a case report

Peripheral edema associated with olanzapine-mirtazapine combination: a case report Peripheral edema is associated with multiple medical etiologies (hepatic cirrhosis, lymphedema, congestive heart failure, hypoproteinemia, and renal disease) and drugs (NSAID, antihypertensives, steroids, and immunosupressive agents). Olanzapine and mirtazapine are rarely associated with peripheral edema. Blockage of alpha 1, M1, H1, and 5HT2 receptors peripherally by olanzapine results in vasodilation and decreased vascular resistance, which may result in peripheral edema. However, the mechanism of peripheral edema caused by the use of mirtazapine is unknown. Here, we report one case of peripheral edema secondary to an olanzapine-mirtazapine combination in a schizophrenic patient. To the best of our knowledge, this is the first report of peripheral edema associated with the combination of olanzapine and mirtazapine.