Assessment of sexual functioning in depressed patients treated with mirtazapine: a naturalistic 6-month study.
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 <or= 7) at endpoint. Only seven patients (9.0%) withdrew the study because of adverse events.


CONCLUSIONS
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.
Saiz-Ruiz
Jerónimo
J
Ramón y Cajal Research Group, Alcala University, Madrid, Spain. jsaiz.hrc@salud.madrid.org
Montes
Jose Manuel
JM
Ibáñez
Angela
A
Díaz
Marina
M
Vicente
Francisco
F
Pelegrín
Carmelo
C
Viñas
Rosa
R
Arias
Francisco
F
Carrasco
Jose Luis
JL
Ferrando
Laura
L
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D000078785:Mirtazapine; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*
D000929:Antidepressive Agents, Tricyclic; D008803:Mianserin; D000078785:Mirtazapine