Sex, stress and sleep

One of the main sequelae to prolonged stressful situations is the development of depressive illness, which is usually accompanied by sexual dysfunction, insomnia and anxiety. The SSRIs that are used to treat depression may themselves aggravate these symptoms further and so delay recovery from the ‘stress-illness vicious circle’. These problems would appear to be considerably less with the newer sedative antidepressant drugs, such as nefazodone and mirtazapine. In a small (N=14) open-label study, data on these factors was recorded before and after 5-weeks treatment with mirtazapine. There were highly significant improvements on the Hamilton Depression and Anxiety rating scales and also on the Sexual Stress and Sleep Problems items of the Wheatley Stress Profile (WSP) (p=0·0001 respectively). © 1998 John Wiley & Sons, Ltd.