Never stop, pause, reduce, or change a prescribed medicine because of anything on this page. Some of the medicines listed here are dangerous to stop suddenly, and the condition being treated does not pause while you experiment. Everything here exists to make your next conversation with a prescriber more specific — not to replace it.
Sometimes reportedAntidepressants
Mirtazapine and sexual side effects
Mirtazapine blocks particular serotonin receptors rather than flooding the system, so orgasm difficulty is reported less often than with SSRIs. Its most prominent effects are strong sedation and appetite increase, and for many people the sex-life impact runs through those rather than through anything genital.
What the rating means: Sexual effects turn up in the reporting for this class without being the typical experience. Worth knowing about, not worth expecting.
What is reported
Editorial categories, not percentages. Published rates vary enormously depending on study design and on whether anyone thought to ask the question.
Wanting sex less often, or losing the spontaneous interest that used to arrive on its own. This is the effect people most often assume is psychological and most often is not only psychological.
Reaching orgasm needs far more time or stimulation than before. Some people find this a welcome effect and some find it exhausting; both reactions are worth saying out loud.
Timing and reversibility
Sedation is heaviest in the first weeks and often eases; for some people it does not, and it is more pronounced at lower doses than higher ones — which surprises people.
Medicine names in this class
mirtazapine, mianserin, noradrenergic and specific serotonergic antidepressant, nassa
Usually prescribed for
Antidepressants
Conditions this is used for
Each of these has its own sexual effects, separate from the medicine’s. Working out which half you are dealing with is usually the whole question.
DepressionThe condition and its treatment pull in the same direction, which makes attribution hard.
What to ask the person who prescribed it
Is the sedation I am getting expected at this dose?
Is the timing of my dose something we can look at?
Are the changes I am noticing the medicine, the depression, or both?
Things that help without touching the prescription
If sedation is the obstacle, moving intimacy earlier in the day is a bigger lever than any product.
Weight and body-image changes are a legitimate part of this conversation and are worth raising even though they feel off-topic.
Common questions
Can mirtazapine affect your sex life?
Sometimes reported for this class. Mirtazapine blocks particular serotonin receptors rather than flooding the system, so orgasm difficulty is reported less often than with SSRIs. Its most prominent effects are strong sedation and appetite increase, and for many people the sex-life impact runs through those rather than through anything genital.
Which sexual side effects are most reported with mirtazapine?
The effects reported most often are fatigue or sedation getting in the way. Reported does not mean guaranteed — plenty of people take these medicines with no change at all, and published rates vary widely depending on whether anyone asked the question.
How soon would mirtazapine cause a change, and does it reverse?
Sedation is heaviest in the first weeks and often eases; for some people it does not, and it is more pronounced at lower doses than higher ones — which surprises people.
What should I do if I notice this while taking mirtazapine?
No. Never stop, pause, or reduce a prescribed medicine on your own because of a side effect — several medicines on this site are dangerous to stop suddenly, and the condition being treated does not pause while you experiment. Bring the observation to the person who prescribed it; a dose review, a different preparation, or a different approach may all be options, and only they can weigh them against what the medicine is doing for you.
What should I ask about mirtazapine at my appointment?
A specific question gets a better answer than a general one. For this class: Is the sedation I am getting expected at this dose? Is the timing of my dose something we can look at? Are the changes I am noticing the medicine, the depression, or both?
Educational information about categories of medicine only — not medical advice, not a diagnosis, and not a statement about your prescription. It does not cover doses, interactions between medicines, or alternatives, and it cannot know what else is going on with your health. Sexual symptoms often have more than one cause at once. Pain, bleeding, or a symptom that is new and unexplained always deserves assessment.