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

Objective To evaluate the effect of mirtazapine augmentation in patients with sexual dysfunction induced by current selective serotonin reuptake inhibitor (SSRI) treatment. Methods Forty-nine outpatients in remission from major depressive disorder with SSRI treatment and experiencing treatment-emergent sexual dysfunction were invited to participate and 33 (25 women and 8 men) were included in this 8-week open-label study. All patients continued her/his current SSRI treatment (dosages unchanged) and started on mirtazapine augmentation of 15 mg/day during the first week and 30 mg/day throughout the rest of the study. The Hamilton rating scale for depression (HAM-D), the psychotropic-related sexual dysfunction questionnaire (PRSexDQ), and the Golombok and Rust Inventory of Sexual Satisfaction (GRISS) were given to all patients at baseline and at each follow-up (end of the first, second, fourth, sixth, and eight weeks). Results Mirtazapine augmentation led to significant reductions in HAM-D, PRSexDQ, and GRISS scores throughout the study especially after week 4 and 48.5% of patients (n = 16) reported that they had no overall sexual dysfunction at the end of the study. Conclusions 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. Copyright (c) 2008 John Wiley & Sons, Ltd.