Description of the medicine: Mianserin

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 of a four-ring structure.

It is considered as "atypical" (by the mechanism of action) antidepressant. The activity of MAO and neuronal capture of monoamines does not inhibit. Increases the release of norepinephrine into the synaptic cleft due to the blockade of presynaptic A2-adrenergic receptors; Also blocks 5-HT2-serotonin receptors.

Holinolytic properties do not.

Timanaleptic action is combined with anxiolytic and moderate sedation.

Quickly absorbed in the digestive tract, but the bioavailability is low (20%) due to the "first passage" through the liver and intestine, Cmax is 2-4 h, T1 / 2 - 32 h; Is excreted mainly by the kidneys and partly by feces.

Applied with reactive and endogenous depressions - both with the phenomena of inhibition, and anxiety.

They use (like other antidepressants) in complex therapy of somatic diseases (including IHD).

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; Elderly appoint 0.03 g (30 mg) per day.

Recently, there have been reports of the use of mianserin (levorin) as an analgesic for tension headache and fibromyalgia (daily doses of 0.03-0.06 g).

The drug is usually well tolerated, including 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 breast-feeding, at 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, monitoring of patients with hepatic, renal and heart failure and glaucoma is mandatory; Each of the first 3 months of administration and if signs of infection, sore throat, a general blood test is necessary; Should refrain from activities (driving, etc.), requiring increased attention and quickness of reactions, as well as from drinking alcohol.

Form release: tablets of 0.01 and 0.03 g (10 and 30 mg) (N. 14, 20).

Storage: List B.