Mianserin

Abstract

Mianserin is a tetracyclic antidepressant whose effects are comparable to those of the classical antidepressants. The drug binds to presynaptic alpha2-adrenoceptors and has no anticholinergic activity. Therefore, an important characteristic of mianserin is its relative lack of anticholinergic effects. Mianserin has also much fewer cardiovascular side effects than tricyclic antidepressants. Since mianserin has a relatively low incidence of cardiovascular and anticholinergic effects it could be particularly suitable in elderly depressed patients. Unfortunately, the elderly are particularly susceptible to the bone marrow suppressive effect shown by the drug. The predominant mianserin adverse effect is drowsiness. Although the efficacy of mianserin in the treatment of depressive illness is established, further clinical studies are needed to indicate whether mianserin is as effective as tricyclics in preventing a recurrence of depressive symptoms.