SERUM MIANSERIN AND AGING

1.Mianserin is a tetracyclic antidepressant with relatively few anticholinergic and cardiovascular side-effects. Its clinical efficacy is comparable to that of tricyclic antidepressants. It is widely used in Europe, especially in elderly outpatients. 2.In the present studies, the authors have evaluated the efficacy of mianserin as well as the effects of ageing and concomitant psychotropic drugs on serum mianserin concentrations in 169 depressive psychiatric inpatients. 3.In the patients the mean serum mianserin concentrations or their interindividual variations did not differ between the old, middle-aged, and young age groups. Furthermore, elderly women and men did not differ from each other for their dose-related drug concentrations. Neither were any differences found in serum mianserin concentrations between the older (greater-than-or-equal-to 75 years) and younger elderly (65-74). As is the case with TCAs, the co-administration of neuroleptics increased serum mianserin concentrations in the elderly. When comparing the therapeutic response and serum mianserin concentrations the authors found that the patients with good clinical improvement had higher mean serum mianserin concentrations than those without efficacy. 4. There seem to be no clinically important changes in the pharmacokinetics of mianserin with advancing age. The present results do not support the claim that the therapeutic profile of this drug is altered with advancing age. Mianserin can be regarded as an antidepressant with relatively few side-effects in the elderly.