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mianserin

N06AX03

Forms & Strengths

Oral tablets: 10 mg
Oral tablets: 30 mg
Oral tablets: 60 mg

Adult Dosing

Initial dose: 30-40 mg daily in divided doses or as a single night-time dose
Maintenance dose: 30-90 mg daily adjusted according to clinical response
Maximum daily dose: 90 mg

Pediatric Dosing

Safety and efficacy in pediatric patients under 18 years have not been established
Use in children and adolescents is generally not recommended

Indications

Treatment of depressive illness requiring pharmacotherapy

Mechanism of Action

Tetracyclic antidepressant
Acts as an alpha-2 adrenergic receptor antagonist leading to increased noradrenaline release
Antagonist at 5-HT2 and 5-HT1C serotonin receptors
Moderate antihistaminic (H1) and low anticholinergic activity

Contraindications

Hypersensitivity to mianserin or excipients
Severe hepatic impairment
History of mania
Concurrent use with MAO inhibitors

Adverse Reactions

Drowsiness and sedation common early in treatment
Bone marrow depression, agranulocytosis (requires monitoring)
Weight gain and increased appetite
Hypotension (orthostatic)
Arthralgia and joint swelling
Elevated liver enzymes

Drug Interactions

MAO inhibitors: risk of severe hypertension and serotonin syndrome
Antihypertensives: may potentiate hypotensive effects
Coumarin anticoagulants: may alter anticoagulant effect
CYP450 inducers/inhibitors: potential alterations in mianserin plasma concentrations

Curated Content: Needs Vetting Before Put to Clinical Use