Pharmacology mianserine

Brogden RN, Heel RC, Speight TM, Avery GS. (1978). Mianserin a review of its pharmacological properties and therapeutic efficacy in depressive illness. Drugs. 16(4) 273-301. 

Mirtazepine (called a Noradrenaline and Selective Serotonin Antidepressant NaSSA) is the 6-aza derivative of mianserin and shares several important pharmacological properties with its predecessor, namely its antihistaminic and alpha-1 adrenoceptor antagonistic actions. Like mianserin, mirtazepine also causes weight gain. Nevertheless, mirtazepine is better tolerated and there is no evidence of blood dyscrasias associated with its clinical use. 

We have attempted to characterize this response further and to define its pharmacology and its utility as a rapid vivo assay for octopaminergic agents, particularly for actions on the CNS (31). The response to OA is specific in that none of the other putative neuroeffectors tested induced a comparable effect with the exceptions of NE and dopamine, both of which are known to have octopaminergic actions of their own. The response to OA was blocked by typical octopaminergic antagonists such as phentolamine, metoclopramide and mianserin (Table II). 

Maprotiline, a tetracyclic compound, largely resembles tricyclic agents in terms of its pharmacological and clinical actions. Mianserine also possesses a tetracyclic structure, but differs insofar as it increases intrasyn-aptic concentrations of norepinephrine... 

Bertschy G., C. Bryois, G. Bondolfi, A. Velardi, P. Budry, D. Dascal, C. Martinet, D. Baettig, and P. Baumann (1997). The association of carbamazepine-mianserin In opiate withdrawal A double blind pilot study versus clonidine. Pharmacological Research 35 451-456. 

The antidepressant mirtazapine is pharmacologically similar to mianserin. It has a slightly weaker blocking action at i-adrenoceptors, and this is claimed to give it a dual mode of action, increasing the release of both noradrenaline and serotonin (1). It is claimed to have a more rapid onset of action than some SSRIs, but this may be due to its prominent sedative effect, which improves insomnia from the start of treatment. 

Mianserin enantiomer concentrations are also influenced, in a stereoselective fashion, by coadministration of the chiral antipsychotic drug, thioridazine, an inhibitor of CYP2D6 [142]. Steady-state plasma concentrations of the S(-l-)-, but not the R(—)-enantiomer, were significantly increased in depressed Japanese patients (about twofold) by the coadministration of thioridazine. At the same time, there were significant increases in plasma concentrations of both R and S enantiomers of desmethylmianserin, which also possess pharmacological activity, after addition of thioridazine. The authors [142] concluded that the S-enantiomer of the parent drug and both enantiomers of desmethylmianserin are likely substrates for CYP2D6. 

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