Premium
Sexual functioning in depressed outpatients taking mirtazapine
Author(s) -
Boyarsky Beth K.,
Haque Waheedul,
Rouleau Mark R.,
Hirschfeld Robert M.A.
Publication year - 1999
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/(sici)1520-6394(1999)9:4<175::aid-da5>3.0.co;2-0
Subject(s) - mirtazapine , orgasm , sexual dysfunction , psychology , sexual function , antidepressant , nefazodone , paroxetine , serotonin reuptake inhibitor , major depressive disorder , arousal , psychiatry , medicine , serotonin , anxiety , fluoxetine , mood , receptor , neuroscience
Objectives—One‐third of patients with untreated depression have sexual difficulties manifested by decreased libido, erectile dysfunction or delayed ejaculation. This dysfunction may be exacerbated by stimulation of post‐synaptic serotonin 5HT2 receptors, a side‐effect of most widely‐used antidepressant medications, especially the selective serotonin reuptake inhibitors (SSRIs). Mirtazapine is an atypical antidepressant with a2 adrenergic antagonist and serotonin 5‐HT2 and 5‐HT3 receptor‐blocking activity. In theory, it should not worsen and perhaps may improve sexual function. This pilot study investigated sexual functioning and antidepressant activity in depressed patients taking mirtazapine. Experimental design—Twenty‐five (F = 18, M = 7) sexually active adult outpatients with a DSM‐IV‐diagnosis of major depressive episode entered a 12‐week, flexible‐dosing, open‐label pilot study. The Arizona Sexual Experiences Scale (ASEX) assessed sexual functioning and the Hamilton Depression Rating Scale (HAM‐D) assessed depressive symptoms on a bimonthly basis. Principal Observations—Desire, arousal/lubrication, and ease/satisfaction of orgasm improved (by 41%, 52%, and 48%, respectively) in the depressed women. In men, desire, arousal/erection, and ease/satisfaction of orgasm also improved (by 10%, 23% and 14%, respectively) but much more modestly. HAM‐D, Clinical Global Impression (CGI) Sheehan Disability Scale (SDS), and Symptom Checklist‐90 (SCL‐90) scores improved in both groups. There was a 50% dropout rate among women before six weeks of treatment. However, the ASEX and HAM‐D scores of the groups terminating before and after six weeks of treatment showed similar rates of improvement. Conclusions—Mirtazapine has a beneficial effect on sexual functioning in both depressed women and men. Longer‐term double‐blind research assessing sexual function during the administration of mirtazapine as well as other antidepressants is recommended. Depression and Anxiety 9:175–179, 1999. © 1999 Wiley‐Liss, Inc.