Mianserin

Mianserin can be used under the supervision of a psychiatrist for patients with treatment-resistant major depression, or if the patient has responded well to it previously.

Mianserin has fewer cardiovascular and anticholinergic adverse effects and a wider margin of safety in overdose than tricyclic antidepressants (TCAs). A full blood count is required before starting treatment and should be repeated at 4 to 6 weeks or if there are any clinical features suggestive of neutropenia (eg infection, sore throat).

An appropriate regimen in adults or young people is:

mianserin 30 mg orally, at night. Increase as tolerated by 10 to 20 mg at weekly intervals to a target dose of 60 to 90 mg at night. If response is inadequate, further dose increases may be needed to a maximum daily dose of 120 mg. major depression mianserin mianserin mianserin