Mirtazapine in Cancer-related Poly-symptomatology

Inclusion Criteria

• •Being over 18 years old
• •Suffering from advanced cancer
• •Having a clinically estimated life expectancy over 3 months.
• •Being diagnosed from having a depressive syndrome by a Hospital Anxiety and Depression Scale-D over 11.
• •Being in need of an antidepressant treatment.
• •Suffering from at least one under-controlled symptom (defined as a score over 3 on the Edmonton Symptom Assessment Scale) among: pain, nausea, vomiting, breathlessness, lack of appetite, sleep disorders, anxiety or impaired wellbeing.
• •Having or not a cancer treatment.
• •Being able to understand the information related to the study, and to sign informed consent.
• •Having agreed to take part to the study.
• •Being able to fill Patient Reported Outcomes questionnaires.
• •Being available to be call on days 7 and 14.
• •Having a social security affiliation.
• •Having or having history of closed-angle glaucoma.
• •Having bone marrow aplasia.
• •Practicing breast-feeding or being pregnant.
• •Women of childbearing age with no contraception method.
• •Having a treatment with:
• •Monoamine oxidase inhibitors (Selegiline, Moclobemide, Isocarboxazid, Nialamide, Phenelzine, Tranylcypromine, Iproniazid, Iproclozide, Toloxatone, Linezolid, Safinamide, Rasagiline)
• •One of the following antiarrhythmic drugs: Flecainide, Propafenone, any class IA and III antiarrhythmic drug (amiodarone, disopyramide, hydroquinidine, quinidine, procainamide, sparteine, ajmaline, prajmaline, lorajmine, bretylium tosilate, bunaftine, dofetilide, ibutilide, tedisamil, dronedarone).
• •Linezolid, sparfloxacin, moxifloxacin, macrolides (IV erythromycin, josamycin, clarithromycin, telithromycin), pentamidin, halofantrine, HIV protease inhibitors (ritonavir, nelfinavir, amprenavir, indinavir), azolic antifungal agents (ketoconazole, itraconazole, miconazole, fluconazole, voriconazole)
• •Mizolastine and Astémizole
• •St. John's wort
• •Having genetic galactose intolerance or glucose-galactose malabsorption.
• •Having one of the following electrolyte disorders not corrected at the time of inclusion: hyponatremia, hyperkalemia, hypokalemia, hypermagnesemia, and hypomagnesemia.
• •Having end-stage renal disease with a creatinine clearance inferior to 15 ml/min calculated using the Cockroft's formula.
• •Having hepatic failure.
• •Having legal incapacity