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Mirtazapine substitution in SSRI-induced sexual dysfunction
A J Gelenberg1, C McGahuey, C Laukes
1Department of Psychiatry, The University of Arizona Health Services Center, Tucson, USA.
The Journal of Clinical Psychiatry
|June 10, 2000
Summary
Switching to mirtazapine effectively treated sexual dysfunction caused by SSRIs, with most patients regaining normal sexual function and maintaining antidepressant response. This offers a viable alternative for managing depression and its side effects.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Selective serotonin reuptake inhibitors (SSRIs) commonly cause sexual side effects, leading to treatment discontinuation.
- Mirtazapine, a serotonin-2/3 receptor antagonist, is associated with fewer sexual problems.
Purpose of the Study:
- To evaluate the efficacy of mirtazapine in treating SSRI-induced sexual dysfunction.
- To assess the impact of switching to mirtazapine on sexual functioning and depressive symptoms.
Main Methods:
- Nineteen patients with SSRI-induced sexual dysfunction and in remission from depression were switched to open-label mirtazapine.
- Mirtazapine dosage was titrated up to 45 mg daily over 6 weeks.
- Sexual functioning (ASEX) and depression (HAM-D) were assessed weekly.
Main Results:
- 58% of patients experienced a return to normal sexual functioning; an additional 11% reported significant improvement.
- All patients maintained their antidepressant response, with a mean HAM-D score of 6+/-3 after 6 weeks.
- Common side effects included initial sedation, irritability, and muscle soreness; 3 patients experienced weight gain.
Conclusions:
- Mirtazapine is an effective antidepressant option for patients experiencing sexual dysfunction due to SSRIs.
- Switching to mirtazapine can resolve SSRI-induced sexual side effects while maintaining depression remission.