by Dr. Manura Nanayakkara

Created on: July 24, 2010   Last Updated: July 25, 2010

Mianserin is a drug prescribed in depression. It is a presynaptic alpha 2 adrenoreceptor blocker. In addition, it has noradrenalin reuptake inhibition properties and antihistamine actions. This drug increases serotonin and noradrenalin neurotransmission in the brain. This results in antidepressant properties as well as its side effects. Most problematic side effect is reduced white cell counts in the blood.

 What the doctor should know before prescribing Mianserin?

If the patient has heart problem, low blood pressure, urinary retention, increased eye pressure, diabetes mellitus, psychotic disorder, history of seizures, bipolar disorder, kidney disease or liver disease, then he/she must discuss with the doctor before taking Mianserin.

 The doctor should know, whether the patient is pregnant or breast feeding as well. Senior citizens may not tolerate this medication, due to its Anticholinergic side effects.

Before prescribing this medication, doctor should know patients complete medications history including all over the counter drugs and the herbal medications he/she is currently on. Especially, this medication should not be used with MAO (Monoamine Oxidase) inhibitors.

 What the patient should know before taking Mianserin?

Mianserin is available as tablets; it should be taken as a whole without crushing with a full glass of water to minimize side effects. It can be taken without regard to the meals. Do not share this medication with anyone. Take this medication according to the advice.

 This medication is known to cause serious reduction of the white blood cell counts. So patients are advised to report any fever, sore throat, or other signs of infections to the doctor immediately. Patients need to monitor their white cell counts monthly during the first three months of treatment.

What are the common side effects?

 Drowsiness is the commonest side effect, especially early in the treatment. So patient must not drive or operate machinery during the course of the treatment. But they can do these activities, once the side effects are significantly lowered over the time.

 Postural hypotension is another troublesome side effect, especially in the elderly patients. So the patient must not get up from the bed quickly, after getting up from the sleep. They should first sit in the bed, and then gradually get up from the bed.

What are the rare side effects?

Anticholinergic side effects such as dry mouth, blurred vision, urine retention, and increased heart rate are can occur rarely, especially early in the drug treatment. These side effects gradually disappear after some time. Sexual dysfunction is another uncommon but annoying side effect. Weight gain is another long term side effect due to its anti histamine properties.

 Tremor, edema, dizziness, abnormal dreams, confusion, anxiety, insomnia, muscle and joint pains are also common in some patients

 Sources

BNF

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