A case of emetophobia responding to mirtazapine and propranolol treatment

Emetophobia (“phobia of vomiting and nausea” or “Specific Phobia- Other [Vomiting]” in Diagnostic and statistical manual of mental disorders-Fifth Edition [DSM-5]) is characterized by impairing, chronic phobic avoidance of nausea/vomiting as well as inordinate cognitive and autonomic responses when avoidance is not possible.1,2 Patients may have elevated disgust sensitivity, a tendency to display gastrointestinal symptoms of anxiety as well as misinterpretation of those symptoms as catastrophic.2 Data on pharmacological management of emetophobia among adolescents is limited with only 2 cases benefiting from selective serotonin reuptake inhibitors (fluoxetine and sertraline) while adults may also benefit from benzodiazepines. 3-5 Patients may apply to various medical specialty clinics for treatment and this may delay diagnosis and management. Here; we aim to present an adolescent with emetophobia and its management by mirtazapine and propranolol.