Mirtazapine augmentation in depressed patients with sexual dysfunction due to selective serotonin reuptake inhibitors

Ozmenler, Nahit; Karlıdere, Tunay; Bozkurt, Ali; Yetkin, Sinan; Doruk, Ali; Sütçigil, Levent; Cansever, Adnan; Uzun, Özcan; Özgen, Fuat; Özşahin, Aytekin

doi:10.1002/hup.929

Cited by 55 publications

(30 citation statements)

References 23 publications

(26 reference statements)

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“…Novel nonSSRI antidepressants like agomelatine and mirtazapine lack sexual side effects [50]. Augmentation therapy with mirtazapine seems to decrease the sexual side effects of SSRIs [51,52] supporting the notion of SSRI-induced sexual dysfunction mediated via 5-HT 2C receptors. S32006 is a very selective 5-HT 2C receptor antagonist, has antidepressant effects in preclinical depression models and elevates extracellular DA and NA, but not 5-HT [53,54].…”

Section: Sexual Dysfunctionmentioning

confidence: 90%

Sexual Dysfunction, Depression and Antidepressants: A Translational Approach

Olivier¹,

Franco²,

Waldinger³

et al. 2017

Sexual Dysfunction

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Major depression is frequently associated with sexual dysfunctions. Most antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), induce additional sexual side effects and, although effective antidepressants, deteriorate sexual symptoms, which are the main reason that patients stop antidepressant treatment. Many strategies have been used to circumvent the additional sexual side effects, but results are rather disappointing. Recently, new antidepressants have been introduced, vilazodone and vortioxetine, which seem to lack sexual side effects in the early registration trials. Much research with large numbers of depressed patients and adequate methodological tools still has to confirm in daily use the absence of sexual side effects of new antidepressants. Animal models that in an early phase of drug development may predict putative sexual side effects of new antidepressants are extremely useful and could speed up development of new antidepressants. A rat model of sexual behavior is described that has a very high predictive validity for sexual side effects in man. Several characteristics of present antidepressants with regard to sexual dysfunctions are also present in the rat model and establish its validity. The animal model can also be used in the search for new psychotropics without sexual side effects or for drugs with sexual stimulating activity.

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Section: Sexual Dysfunctionmentioning

confidence: 90%

Sexual Dysfunction, Depression and Antidepressants: A Translational Approach

Olivier¹,

Franco²,

Waldinger³

et al. 2017

Sexual Dysfunction

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“…The efficacy of augmentation strategies with mirtazapine has been investigated through several studies. Ozmenler et al evaluated the effect of using mirtazapine as an augmentation agent in patients with residual SD despite the remission of depressive symptoms with antidepressant therapy [115]. The patients remained on their antidepressant, 36.4% remaining on paroxetine, 27.3% on sertraline, 21.2% on citalopram and 15.1% on fluoxetine.…”

Section: Mirtazapinementioning

confidence: 97%

Sexual dysfunction associated with major depressive disorder and antidepressant treatment

Clayton

Haddad

Iluonakhamhe

et al. 2014

Expert Opinion on Drug Safety

105

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Depression and SD have a bidirectional association. When screening for depression, baseline sexual functioning should be assessed with validated rating scales. If sexual side effects develop with antidepressant treatment, management options include waiting for spontaneous remission, decreasing the medication dose, switching to an alternative drug or adding an augmentation agent or antidote. Research suggests that bupropion and newer antidepressants exhibit a more favorable SD profile compared with other antidepressants, especially selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors. Bupropion, mirtazapine and buspirone have been studied as augmentation agents/antidotes or substitution agents in management of AASD. Future studies validating genetic factors could enable personal genotyping to guide individualized treatment and also facilitate the development of enhanced therapeutic guidelines to avoid or manage AASD.

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“…On the basis of this it is claimed that in comparison to SSRIs and ven afaxine, mirtazapine is significantly less likely to produce sexual dysfunction [34][35][36]. Ozmenler et al [37] also reported that when remitted patients with SSRI-induced sexual dysfunction were switched to mirtazapine, approximately half of them reported no sexual dysfunction at the end of the 8-week treatment. There is also preliminary evidence to suggest that mirtazapine improves duloxetine-induced sexual dysfunction [36,37].…”

Section: Role Of Agents With Dual Actions On Serotonin and Norepinephmentioning

confidence: 99%

Sexual Dysfunctions in Depression

J¹,

Rao²,

Chandran³

et al. 2017

Clin Depress

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Sexual dysfunction is one of the common symptoms seen in depression. Presentations include decreased libido, erectile dysfunction, arousal difficulties and orgasm related dysfunctions. The probable causes of sexual dysfunction in such patients are complex and biological, psychological as well as psychosocial factors are likely to play an important role. Sexual dysfunction could also occur as an adverse effect of anti-depressants although it is difficult to establish whether the dysfunction is due to the illness or the medication. Awareness among professionals about sexual dysfunction is essential as it can have a profound impact in terms of relationship conflict, marital satisfaction, quality of life and compliance with treatment in patients with depression.

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Mirtazapine augmentation in depressed patients with sexual dysfunction due to selective serotonin reuptake inhibitors

Abstract: Mirtazapine augmentation is a good choice for the treatment of SSRI-induced sexual dysfunction, and the results are typically seen later after 4-8 weeks.

Cited by 55 publications

References 23 publications

Sexual Dysfunction, Depression and Antidepressants: A Translational Approach

Sexual Dysfunction, Depression and Antidepressants: A Translational Approach

Sexual dysfunction associated with major depressive disorder and antidepressant treatment

Sexual Dysfunctions in Depression

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