Mianserin

Indications
 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.
Contraindications
 lactation, porphyria.
Warnings / 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.
Adverse Reactions
 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.
Overdose Reactions
 Symptoms are prolonged sedation, tachycardia and/or bradycardia. Treat with gastric lavage and supportive treatment.
Drug 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).
See Below for More mianserin Drug Interactions
Mechanism of Actions
 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 α2-receptors, thus leading to an increase in noradrenaline release.
Absorption: Readily absorbed from the GIT (oral).
Distribution: Widely distributed; crosses the blood-brain barrier; enters breast milk. Protein-binding: Extensive.
Metabolism: Extensively hepatic by aromatic hydroxylation, N-oxidation, N-demethylation.
Excretion: Urine (as metabolites), faeces (small amounts); 6-40 hrs (elimination half-life).
Administration
 May be taken with or without food.
ATC Classification
 N06AX03 - mianserin ; Belongs to the class of other antidepressants.
Available As
  • Mianserin 10 mg
  • Mianserin 20 mg
  • Mianserin 30 mg

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