Mianserin
group of stereoisomers
Mianserin, sold as Tolvon and other brand names, is an atypical antidepressant used primarily for treating depression in Europe and other countries. It is a tetracyclic antidepressant (TeCA) and is closely related to mirtazapine in terms of chemical structure, actions, and effects, although mianserin has greater noradrenergic activity and less 5-HT3 receptor antagonism.
Medical uses
Mianserin is used at higher doses (30–90 mg/day) for the treatment of major depressive disorder. At lower doses (around 10 mg/day), it is used to treat insomnia.
Contraindications
It should not be given, except if based on clinical need and under strict medical supervision, to people younger than 18 years old, as it can increase the risk of suicide attempts and suicidal thinking, and it can increase aggressiveness.
While there is no evidence that it can harm a fetus from animal models, there are no data showing it safe for pregnant women to take.
People with severe liver disease should not take mianserin, and it should be used with caution for people with epilepsy or who are at risk for seizures, as it can lower the threshold for seizures. If based on clinical decision, normal precautions should be exercised and the dosages of mianserin and any concurrent therapy kept under review and adjusted as needed.
Side effects
Very common (incidence > 10%) adverse effects include constipation, dry mouth, and drowsiness at the beginning of treatment.
Common (1% < incidence ≤ 10%) adverse effects include drowsiness during maintenance therapy, tremor, headache, dizziness, vertigo, and weakness.
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