Mirtazapine - 'interesting' side effects...

Antidepressant-induced sexual dysfunction is a frequent side effect which may greatly contribute to treatment non compliance. Mirtazapine has a pharmacological profile expected to result in a lack of sexual dysfunction. The main purpose of this 6-month open-label study was to evaluate the effects of mirtazapine on sexual function of a sample of depressed patients.

METHODS: Seventy-eight patients meeting DSM-IV criteria for major depression or adjustment disorder with depressed mood or with mixed anxiety and depressed mood, sexually active prior to the episode, were treated with mirtazapine (15-60 mg/day). Effectiveness was assessed using the 17-item Hamilton rating scale for depression (HAM-D-17), the Hamilton rating scale for anxiety (HAM-A) and the clinical global impression (severity and improvement) scales (CGI). Sexual function was evaluated with the psychotropic-related sexual dysfunction questionnaire (PRSexDQ) which detects clinical changes in sexual dysfunction.

RESULTS: Forty-eight patients (61.5%) were experiencing sexual dysfunction at baseline. A return to normal sexual functioning was observed in 27 of 38 (71.1%) patients completing the study. Significant reductions in mean total PRSexDQ scores were detected at day 90 and endpoint and only four patients withdrew or required dose reduction due to mirtazapine-induced sexual dysfunction. A total of 37 patients (47.4%) achieved complete remission of depression (HAM-D-17 score < /= 7) at endpoint. Only seven patients (9.0%) withdrew the study because of adverse events.

CONCLUSION: Mirtazapine showed in this study that it is an effective and well-tolerated antidepressant treatment with a possibly lower incidence of sexual side effects than other antidepressants.