Posted by SalArmy4me on July 10, 2001, at 1:41:16
Farah, Andy MD. Lack of sexual adverse effects with mirtazapine. American Journal of Health-System Pharmacy. 55(20):2195-2196, October 15, 1998:
I treated four female patients, ages 30-49 years, who had a loss of libido during SSRI therapy for depression with or without panic disorder; one of them also had anorgasmia. Three of the women were taking paroxetine 20 or 30 mg/day (as the hydrochloride salt), and the other was taking fluoxetine 30 mg/day (as the hydrochloride salt). Resolution of sexual dysfunction was reported by all four patients soon after mirtazapine 15 mg/day was added to their regimen. Despite the fact that mirtazapine and SSRIs have serotonergic activity, albeit by different mechanisms, none of the women had symptoms of a serotonin syndrome.
There are several possible explanations for the resolution of sexual dysfunction with mirtazapine therapy. Antagonism at 5-HT2 receptors may have a favorable effect on SSRI-induced sexual dysfunction. Serotonin seems to be primarily inhibitory in its effect on libido, arousal, and orgasm, possibly by mediating the mesolimbic dopaminergic system such that the pathway may be inhibited by serotonergic input to 5-HT2 receptors. In addition, serotonin's inhibitory effect on sexual function is counterbalanced by the activating effect of dopamine. Therefore, drugs that block 5-HT2 receptors (e.g., nefazodone, mirtazapine) or promote dopamine activity (e.g., bupropion, dextroamphetamine) can reverse SSRI-induced loss of libido or sexual pleasure."
poster:SalArmy4me
thread:69567
URL: http://www.dr-bob.org/babble/20010708/msgs/69567.html