A case of mirtazapine-induced spontaneous orgasms in a female patient

This is a case report of a 51-year-old woman admitted as a psychiatric outpatient with symptoms of moderate to severe depression and anxiety. She had received anti-depressants prior to her admission. The patient did not have a medical history of mania or hypomania, and did not complain of any sexual side-effects when taking prior medications. She was diagnosed in our clinic with mixed anxiety-depressive disorder. Due to lack of improvement she was commenced on mirtazapine and after three days complained of spontaneous orgasms and increased libido. The sexual symptoms resolved gradually after a few days and reappeared upon every dosage increase. On discontinuation of mirtazapine the side effects subsided. To the best of the author's knowledge this is the first report of spontaneous orgasms following treatment with mirtazapine.