Mianserin is a tetracyclic antidepressant primarily used in the treatment of major depressive disorder. It was developed in the early 1970s by the Dutch pharmaceutical company Organon as an alternative to tricyclic antidepressants with fewer anticholinergic and cardiovascular side effects. The drug works mainly by blocking central alpha-2 adrenergic receptors, which increases the release of norepinephrine and serotonin in the brain. Mianserin also antagonizes serotonin (5-HT₂) and histamine H₁ receptors, contributing to its antidepressant and sedative effects. Due to its calming properties, it is especially useful in patients with depression accompanied by anxiety and insomnia. During post-marketing use, rare but serious adverse effects such as agranulocytosis were reported. This led to recommendations for careful monitoring and more cautious prescribing. Over time, the introduction of newer antidepressants like SSRIs and SNRIs reduced its widespread use. Despite this, mianserin remains available in some countries. It continues to be prescribed for selected patients where sedation is beneficial.
BRAND NAMES
Mianserin is marketed globally under several brand names, such as Tolvon, Lumin, Lerivon, Depnon, and Tetradep. Although it is not approved for use in the United States, the drug is commonly available in Europe, Australia, and various other countries.
