Description of the medicine: Mianserin (Mianserin)
1,2,3,4,10,14b-hexahydro-2-methyldibenzo- [c, f] pyrazino- [1,2-a] azepine hydrochloride.
Synonyms: Lerivon, Miansan, Bolvidon, Lerivon, Miansan, Norial, Tolvin, Tolvon.
Antidepressant four-cycle structure.
It is considered as an “atypical” (by the mechanism of action) antidepressant. MAO activity and neuronal uptake of monoamines does not inhibit. Increases the release of norepinephrine into the synaptic cleft due to blockade of presynaptic A2-adrenergic receptors; also blocks 5-HT2-serotonin receptors.
It does not have anticholinergic properties.
Timoanaleptic effect is combined with anxiolytic and moderate sedative effect.
Quickly absorbed in the digestive tract, but bioavailability is low (20%) due to the "first passage" through the liver and intestines, Cmax is 2-4 hours, T1 / 2 - 32 hours; It is excreted mainly by the kidneys and partially with feces.
It is used for reactive and endogenous depression - both with phenomena of inhibition and anxiety.
Use (like other antidepressants) in the treatment of somatic diseases (including coronary heart disease).
The initial dose is usually 0.01 g (10 mg) 2-3 times a day, gradually increasing it to 0.03-0.09 g (30-90 mg) per day; the elderly are prescribed 0.03 g (30 mg) per day.
Recently, there has been evidence of the use of mianserin (levorin) as an analgesic for tension headaches and fibromyalgia (daily doses - 0.03-0.06 g).
The drug is usually well tolerated, including by elderly patients.
Possible side effects: drowsiness, arterial hypotension, impaired liver function, jaundice, leukopenia, agranulocytosis, arthralgia, etc.
The drug is contraindicated in manic syndrome, impaired liver function, acute myocardial infarction, pregnancy and lactation, under the age of 18 years.
Incompatible with MAO inhibitors (2-week interval); enhances the effects of alcohol and antihypertensive drugs and weakens antiepileptic drugs.
During treatment, observation of patients with hepatic, renal and heart failure and glaucoma is mandatory; each of the first 3 months of use and when signs of infection, sore throat appear, a general blood test is necessary; should refrain from activities (driving a car, etc.) that require increased attention and speed of reactions, as well as from drinking alcohol.
Release form: tablets of 0.01 and 0.03 g (10 and 30 mg) (N. 14, 20).
Storage: List B.