Mianserin

Registered South African indications:

• Depression

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe hepatic impairment
• Mania
• Coadministration with monoamine oxidase (MAO) inhibitors or within 2 weeks of cessation of therapy with MAO inhibitors
• Children and adolescents under 18 years of age

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Mild to moderate hepatic impairment
• Elderly
• Children
• History of suicide-related events
• Significant suicidal ideation
• Recent myocardial infarction
• Heart block
• Arrhythmia
• Epilepsy
• Risk factors for seizures
• Diabetes mellitus
• Narrow angle glaucoma
• Prostatic hypertrophy
• Bipolar disorder
• Hypomania
• Patients undergoing elective surgey
• Phaeochromocytoma

Forms avail. in SA and covered in this monograph: tab

Depression

• Oral (tab): Initial: 30-40mg, dly in the evening; Maintenance: 30-90mg, dly

Not established for use in children below 18 years

Pregnancy

• Caution; not recommended
• Do not use during pregnancy unless there are compelling reasons. There is no evidence of safety in human pregnancy. Animal studies have not shown hazard

Breastfeeding

• Caution

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Mild to moderate: Caution; no dose adjustment recommended
• Severe: Contraindicated

Elderly

• Caution; dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warning

Central Nervous System Disorders

• Suicidal ideation
• Suicidal behaviour
• Psychosis
• Mania
• Hypomania
• Impaired sexual function
• Withdrawal
• Dizziness
• Tremor
• Seizures

Cardiovascular Disorders

• Postural hypotension
• Oedema

Hepatobiliary Disorders

• Impaired hepatic function
• Jaundice

Endocrine and Metabolic Disorders

• Hyponatraemia
• Gynaecomastia
• Nipple tenderness
• Lactation

Musculoskeletal Disorders

• Arthralgia
• Polyarthropathy
• Arthritis

Skin and Subcutaneous Tissue Disorders

• Skin rash
• Sweating

Immune, Blood and Lymphatic System Disorders

• Bone marrow depression
• Granulocytopenia
• Agranulocytosis
• Leucopenia
• Aplastic anaemia

• Central nervous system depressants
• Monoamine oxidase inhibitors
• Moclobemide
• Antiepileptics
• Primidone
• Neuroleptics
• Atomoxetine
• Diazoxide
• Hydralazine
• Nitroprusside
• Warfarin
• Antihistamines
• Antimuscarinics
• Apraclonidine
• Brimonidine
• Sibutramine
• Artemether with lumefantrine

Full blood count

Mianserin is a tetracyclic antidepressant. It does not appear to have significant anticholinergic properties, but has a marked sedative action. It blocks presynaptic alpha adrenoceptors and increases the turnover of brain noradrenaline. It has little effect on central serotonin uptake but has been shown to increase peripheral serotonin uptake in depressed subjects. It has antihistamine properties. Its mode of action in depression is not fully understood.

Tablet 10mg

• Lantanon (Adcock) originator

Tablet 30mg

• Lantanon (Adcock) originator