Mianserin

Indications

Mianserin is used for: Depression

Adult Dose

Oral Depression Adult: Initially, 30-40 mg daily gradually increased if necessary. Maintenance: 30-90 mg daily as a single dose at night or in divided doses. Max: 200 mg/day. Elderly: Initially, 30 mg slowly increased if necessary.

Child Dose

Renal Dose

Administration

May be taken with or without food.

Contra Indications

lactation, porphyria.

Precautions

Concurrent CNS depression; epilepsy; MAOIs withdrawal (at least 14 days after discontinuation); hepatic, renal or cardiac insufficiency; heart block or recent MI; angle-closure glaucoma; prostatic hyperplasia; diabetes mellitus; monitor blood count regularly.

Pregnancy-Lactation

Interactions

Blood levels decreased by phenobarbitone, carbamazepine and phenytoin. Monitor blood pressure with antihypertensive therapy. Mianserin may antagonise the action of antiepileptics by lowering the convulsive threshold. CNS depressant effects enhance by alcohol, sedatives. Potentially Fatal: Avoid MAOIs (and for 14 days after discontinuation).

Adverse Effects

Side effects of Mianserin : Drowsiness; liver dysfunction and jaundice; gynaecomastia; convulsions; hypomania; hypotension; hypertension; coma; arthralgia; oedema; tachycardia; bradycardia; vomiting; dizziness and ataxia; anticholinergic effects. Potentially Fatal: Bone marrow suppression.

Mechanism of Action

Mianserin is a structural analogue of serotonin (5-HT) with antagonistic effects at 5-HT2A, 5-HT2C and 5-HT3 receptors. Mianserin also blocks the inhibitory alpha2-receptors, thus leading to an increase in noradrenaline release.