Sexual functioning in depressed outpatients taking mirtazapine

Boyarsky, Beth K.; Haque, Waheedul; Rouleau, Mark R.; Hirschfeld, Robert M. A.

doi:10.1002/(sici)1520-6394(1999)9:4<175::aid-da5>3.0.co;2-0

Cited by 58 publications

(26 citation statements)

References 14 publications

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“…According to one study, in depressed patients, 65% of men and 48% of women reported disordered sexual interest or satisfaction (Zajecka et al, 2002). Lower rates have been also reported (Boyarsky, Haque, Rouleau, & Hirschfeld, 1999;Landen, Eriksson, Agren, & Fahlen, 1999). The findings of our study regarding the link between age and sexual desire is consistent with other study results (Seg- raves & Segraves, 1991).…”

Section: Discussionsupporting

confidence: 91%

“…The literature suggests that there are some links between the type of depression treatment (Eisendrath et al, 2008), degree of improvement in depressive symptoms (Rupke et al, 2006), and gender (Boyarsky et al, 1999;Landen et al, 1999) with sexual desire/function improvement in depression treatment. Regarding gender, very few studies have shown equal improvement among genders (Ekselius & von Knorring, 2001), and many have shown the higher improvement in sexual desire in women than men (Boyarsky et al, 1999;Landen et al, 1999), or to be seen just in women (Piazza et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

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Psychological Treatment of Major Depression: An Analysis of the Sexual Desire

Mohammadkhani

Dobson

Tamannaeifar

et al. 2016

PCP

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Objective: Sexual dysfunction is frequently reported as a side effect of many antidepressant medications. As a result, for those depressed patients to whom sexual desire is important, psychological treatment may be a better intervention. Thus, the present study aimed to determine the possible changes in sexual desire following psychological treatments in depression, when focus of therapy is not on sexual function.Methods: This is a quasi-experimental study, which was conducted in Tehran, Iran. A total of 281 depressed patients in the remission phase underwent psychological treatments, either cognitive behavioral therapy (CBT, n=131) or mindfulness-based cognitive therapy (MBCT, n=150). The therapy did not focus on any aspect of sexual function. Using a single item measure before and after treatment, sexual desire of the patients was categorized into intact, mild, moderate, or severe decline. A total of 255 participants completed the study questionnaires and were randomly assigned to CBT (122) and MBCT groups (133). Before therapy, 128(50.2%) participants were categorized in intact sexual desire group, 73(28.6%) in mild sexual desire dysfunction group, 40(15.7%) in moderate sexual desire dysfunction group, and 14(5.5%) in severe sexual desire dysfunction group. Logistic regression was used for analyzing the data by SPSS-16. Results Conclusion:CBT might be superior to MBCT in improving sexual desire in patients with depression. Further studies using validated sexual function questionnaires are necessary.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Psychological Treatment of Major Depression: An Analysis of the Sexual Desire

Mohammadkhani

Dobson

Tamannaeifar

et al. 2016

PCP

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“…A second study, of 11 patients who stopped SSRIs because of sexual problems, found that mirtazapine did not result in the reemergence of sexual dysfunction (Koutouvidis et al, 1999). These observations are supported by findings in a group of 25 out-patients with depression, indicating that mirtazapine had beneficial effects on sexual function (Boyarsky et al, 1999).…”

Section: Antidepressant Augmentation or Switching Studiesmentioning

confidence: 77%

Sexual side-effects of antidepressant and antipsychotic drugs

Baldwin¹,

Mayers

2003

Adv. psychiatr. treat

151

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Adequate sexual expression is essential to many human relationships and provides a sense of physical, psychological and social well-being. Epidemiological and clinical studies show that depression and schizophrenia are associated with impairment of sexual function and satisfaction, even in untreated patients. Most antidepressant and antipsychotic drugs have adverse sexual effects but it is difficult accurately to identify the incidence of treatment-emergent dysfunction, as disturbances can be reliably detected only from systematic enquiries made at baseline and during treatment. Growing awareness of the adverse effects of psychotropic drugs has led to attempts to use adjuvants or substitute treatments to resolve sexual dysfunction. More studies of the effects of antidepressant and antipsychotic drugs on sexual function are needed. AbstractThe normal sexual response is conventionally divided into the four phases listed below, and disorders can occur at one or more of these phases.(1) Desire: typically this consists of fantasies about, and the desire to have, sexual activity. (2) Excitement: a subjective sense of sexual pleasure and accompanying physiological changes, namely penile tumescence and erection in men and pelvic vasocongestion, swelling of the external genitalia, vaginal lubrication and expansion in women. (3) Orgasm: this is when sexual pleasure peaks, with release of sexual tension and rhythmic contraction of the perineal muscles and reproductive organs. In men, the sensation of ejaculatory inevitability is followed by ejaculation of semen. In women, contractions of the outer third of the vaginal wall occur. (4) Resolution: a sense of muscular relaxation and general well-being. Men are physiologically refractory to erection and orgasm for a variable period after orgasm, whereas women may respond to further stimulation.The ICD-10 (World Health Organization, 1992) uses the term 'sexual dysfunction' to cover the ways in which an individual is unable to participate in a sexual relationship as he or she would wish. This classification has 10 subdivisions (F52.0-F52.9), each describing different forms of dysfunction. The DSM-IV (American Psychiatric Association, 1994) uses a similar scheme. Whenever possible, doctors should specify which form of sexual dysfunction is present, as these have differing causes and require different treatment approaches.Some types of dysfunction occur in both men and women, although women tend to present with complaints about the subjective quality of sexual experience (e.g. lack of desire), whereas men often describe the failure of a specific response (such as erection) but a continuing sexual desire. Epidemiology of sexual dysfunctionThis area has not been studied extensively. Nathan (1986) evaluated 22 studies of sexual behaviour in the general population but concluded that methodological problems in the surveys meant that only broad estimates could be made. The prevalence of inhibited sexual desire was 16% for men, 35% for women; for erectile dysfunction and premature ejacul...

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“…Some patients dropped out due to drowsiness or other adverse events, emphasizing the importance of determining which side effects are a priority to the patient. 24 In contrast with the smaller studies, a randomized, double-blind, placebo-controlled study of mirtazapine (15 mg/day), yohimbine (5.4 mg/day), and olanzapine (2.5 mg/day) found no improvement in sexual function with treatment compared to placebo. 25 There…”

Section: Switch To or Add Mirtazapinementioning

confidence: 94%

“…One study of 25 patients reported improved desire, arousal, and orgasm during treatment with mirtazapine monotherapy (flexible dosing, maximum dose of 45 mg/day). 24 HAM-D scores also dropped significantly. In this study, 16 patients dropped out of the study or were lost to followup.…”

Section: Switch To or Add Mirtazapinementioning

confidence: 95%