Mianserin

Oral
Depression

May be taken with or without food.

lactation, porphyria.

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.

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.

Symptoms are prolonged sedation, tachycardia and/or bradycardia. Treat with gastric lavage and supportive treatment.

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).

Description: Mianserin is a structural analogue of serotonin (5-HT) with antagonistic effects at 5-HT_2A, 5-HT_2C and 5-HT₃ receptors. Mianserin also blocks the inhibitory α₂-receptors, thus leading to an increase in noradrenaline release.
Pharmacokinetics:
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).

Antidepressants / Anxiolytics