Can Long-Term Use of Remeron Cause Constipation and Erectile Dysfunction?

Can long-term use of antidepressants cause constipation and erectile dysfunction?

Hello, I have been taking Paxil (paroxetine) long-term, one pill daily.
In June of this year, I switched to Wellbutrin (bupropion), taking one 75 mg pill daily, and then increased it to two pills a day.
Since starting Wellbutrin, I have experienced severe constipation and erectile difficulties.
Are these side effects caused by Wellbutrin? If I stop taking it, will I return to normal? This is very concerning for me.
12/6/2011

Kunrao de ren, 40~49 year old female. Ask Date: 2011/12/06

Dr. Luo Guanlin reply Pharmacology

Constipation and sexual dysfunction are side effects that may occur with the use of fluoxetine.
Generally, it is not recommended to abruptly discontinue antidepressant medications.
If the side effects are intolerable, it is advisable to discuss with a physician the possibility of adjusting the dosage, switching to another medication, or adding medications to alleviate the side effects.

Reply Date: 2011/12/06

More Info

Long-term use of Remeron (Mirtazapine) can indeed lead to side effects such as constipation and erectile dysfunction. Mirtazapine is an atypical antidepressant that works primarily by antagonizing certain serotonin and norepinephrine receptors, which can lead to various side effects due to its pharmacological profile.

Constipation
Constipation is a known side effect of Mirtazapine. The mechanism behind this is related to the drug's action on the central nervous system and its effects on the gastrointestinal tract. Mirtazapine can decrease gastrointestinal motility, leading to slower transit times and, consequently, constipation. This side effect can be particularly bothersome for patients, especially if they are already predisposed to gastrointestinal issues.
If you are experiencing severe constipation, it is essential to discuss this with your healthcare provider. They may recommend dietary changes, increased fluid intake, or even the use of laxatives to help alleviate this issue. In some cases, adjusting the dosage of Mirtazapine or switching to another antidepressant with a more favorable side effect profile may be necessary.

Erectile Dysfunction
Erectile dysfunction (ED) is another potential side effect of Mirtazapine. While it is not as commonly reported as with some other antidepressants, it can occur due to the drug's effects on neurotransmitter systems that regulate sexual function. Mirtazapine's sedative properties and its influence on serotonin levels can contribute to difficulties in achieving or maintaining an erection.

If you are experiencing erectile dysfunction, it is crucial to have an open conversation with your doctor. They can help determine whether Mirtazapine is the likely cause of your symptoms and discuss alternative treatment options. Sometimes, switching to a different class of antidepressants, such as SSRIs or SNRIs, may help alleviate these sexual side effects, although these classes can also have their own sexual side effects.

Recovery After Discontinuation
If you decide to stop taking Mirtazapine, many patients find that their gastrointestinal and sexual function returns to baseline levels after a period of time. However, the timeline for recovery can vary from person to person. Some may notice improvements shortly after discontinuation, while others may take longer for their bodies to readjust. It is essential to taper off the medication under the guidance of your healthcare provider to minimize withdrawal symptoms and ensure a safe transition.

Conclusion
In summary, long-term use of Mirtazapine can lead to constipation and erectile dysfunction. If you are experiencing these side effects, it is essential to consult with your healthcare provider. They can help you assess whether these symptoms are related to Mirtazapine and discuss potential adjustments to your treatment plan. Remember, managing side effects is a crucial part of your overall treatment for depression, and there are often alternative medications or strategies that can help you achieve a better quality of life.

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