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Mirtazapine, sold under the brand name Remeron among others, is an atypical tetracyclic antidepressant, and as such is used primarily to treat depression. [11] [12] Its effects may take up to four weeks but can also manifest as early as one to two weeks.
[38] [39] The condition has however occurred in surprising clinical situations, and because of phenotypic variations among individuals, it has been associated with unexpected drugs, including mirtazapine. [40] [41] The relative risk and severity of serotonergic side effects and serotonin toxicity, with individual drugs and combinations, is complex.
Mirtazapine is reported to have fewer sexual side effects, most likely because it antagonizes 5-HT 2 and 5-HT 3 receptors and may, in some cases, reverse sexual dysfunction induced by SSRIs by the same mechanism.
Tricyclic antidepressants, such as desipramine (Norpramin), doxepin, imipramine (Tofranil), nortriptyline (Pamelor) and protriptyline, and tetracyclic antidepressants, such as mirtazapine (Remeron).
A number of non-SSRI drugs are not associated with sexual side effects (such as bupropion, mirtazapine, tianeptine, agomelatine, tranylcypromine, and moclobemide [57] [58] [59]). Several studies have suggested that SSRIs may adversely affect semen quality. [60] [61]
In addition, due to their blockade of certain serotonin receptors, serotonergic neurotransmission is not facilitated in unwanted areas, which prevents the incidence of many side effects often associated with selective serotonin reuptake inhibitor (SSRI) antidepressants; [1] [3] hence, in part, the "specific serotonergic" label of NaSSAs. [2]