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Sexual Dysfunction Associated With Mirtazapine: A Case Report

J Clin Psychiatry 1998;59(6):319-320 [letter]

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.