Posted by Sad Panda on February 13, 2004, at 9:34:14
Hi all, I see a lot of people on this board complain of SSRI induced anorgasmia.
This little snipet from http://www.preskorn.com/columns/0003.html explains why Mirtazapine(Remeron/Zinspin/Avanza) is great when combined with SSRI's or Efexor.
"While SSRIs are "selective" in terms of directly affecting only the serotonin uptake pump, they are not "selective" in terms of their agonism of serotonin receptors. They increase serotonin availability to all serotonin receptors. Agonism of the 5-HT1A receptor is currently believed to be the mechanism mediating the antidepressant efficacy of these drugs. Conversely, agonism of the 5-HT2A, 5HT2C, and 5-HT3 receptors may principally mediate the adverse effects of these drugs: sleep disturbance, anxiety and weight gain, and nausea/loose stools/vomiting, respectively.
Mirtazapine at antidepressant concentrations blocks the 5-HT2A, 5-HT2C, and 5-HT3 receptors. Thus, the combination of this drug plus an SSRI or venlafaxine could simultaneously treat the adverse effects of these drugs while increasing the availability of serotonin to the 5-HT1A receptor, the putative mechanism mediating their antidepressant efficacy. Mirtazapine also blocks the alpha-2 adrenergic receptor . Thus, mirtazapine could act like yohimbine, another alpha-2 adrenergic antagonist, to treat sexual dysfunction caused by serotonin uptake inhibitors. However, that potentially desirable effect may be offset by its blockade of the histamine-1 receptor (you may simply be too tired to be frisky)."
If you get past the initial startup zombie drowsiness of taking Mirtazapine it makes a great med to add on, especially if you have sleep problems. Only real problem with it is that it increases appetite & weight in some people.
Cheers,
Panda.
poster:Sad Panda
thread:312794
URL: http://www.dr-bob.org/babble/20040210/msgs/312794.html