Sexual Dysfunction Associated With Mirtazapine: A Case Report

Sir: The recently released antidepressant mirtazapine has a unique pharmacologic action that makes it unlike any other antidepressant on the U.S. market today. It is purported to assert its antidepressant effects by antagonizing the presynaptic α₂- adrenergic autoreceptors and heteroreceptors on norepinephrine and serotonin presynaptic axons as well as acting as a postsynaptic antagonist of 5-HT₂ and 5-HT₃. By virtue of this 5-HT₂ and 5-HT₃. blockade, the side effects typically associated with the SSRIs such as nausea, vomiting, diarrhea, insomnia, and sexual dysfunction tend to occur less often with mirtazapine than with placebo.