Mirtazapine Monotherapy for Antipsychotics-refractory Psychosis in a Patient with Very-late-onset Schizophrenia-like Psychosis: A Case Report
Kanji Ueno1, Makoto Ishitobi2, Hirotaka Kosaka1, Kei Ichijo3, Yukihiro Nagase3
1Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
2Department of Psychiatry, Jinkei Hospital, Himeji, Japan
3Department of Psychiatry, Takatsuki Hospital, Hachiouji, Japan
Correspondence to: Makoto Ishitobi
Department of Psychiatry, Jinkei Hospital, 275 Nozato, Himeji, Hyogo 670-0811, Japan
E-mail: mak1977019@yahoo.co.jp
ORCID: https://orcid.org/0000-0001-6848-7044
Received: June 14, 2023; Revised: August 12, 2023; Accepted: September 4, 2023; Published online: September 25, 2023.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Very-late-onset schizophrenia-like psychosis (VLOSLP) is a condition in which psychotic symptoms emerge after the age of 60 years. Given its heterogeneous nature, VLOSLP remains a diagnostic and therapeutic dilemma. Here, we report a case of a 68-year-old patient with psychosis refractory to antipsychotics who was successfully treated with mirtazapine monotherapy. This case suggests that mirtazapine monotherapy may be effective for the treatment of patients with antipsychotic- refractory VLOSLP.
Keywords: Mirtazapine; Antipsychotics-refractory psychosis; Late-onset schizophrenia

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