Indication
Mianserin is a tetracyclic antidepressant that is similar to the tricyclic anti-depressants (TCAs).
When depression occurs, there may be a decreased amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood.

Mianserin works by preventing the re-absorption of noradrenaline back into the nerve cells. It may also act to block certain receptors in the brain that bind released serotonin. This helps enhance and prolong the mood-lightening effect of any released noradrenaline and serotonin, thereby helping relieve depression.

The full benefits of treatment with Mianserin may not appear for two to four weeks.
Mianserin is used to treat depression

Precaution
Do not drink alcohol whilst taking Mianserin.
Mianserin may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how Mianserin effects you and you are sure it won't affect your performance.

Your liver functioning should be monitored while you are taking Mianserin. Symptoms that may suggest a liver problem include persistent nausea and vomiting, abdominal pain, or the development of jaundice (a yellow colouring to the skin and the whites of the eyes). Consult your doctor if you experience any of these symptoms.

You should not suddenly stop taking Mianserin unless your doctor tells you otherwise.

Mianserin may cause low blood sodium levels (hyponatraemia), which can result in drowsiness, confusion, muscle twitching or convulsions. Consult your doctor if you develop any of these symptoms while taking Mianserin.

Your doctor may perform regular blood tests to monitor the composition of your blood while you are taking Mianserin. You should let your doctor know if you experience symptoms such as a fever or sore throat.
If you should require local or general anaesthesia, it is important that you inform your anaesthetist you are taking Mianserin.

Use with caution in
- Closed angle glaucoma
- Decreased kidney function
- Decreased liver function
- Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)
- Diabetes
- Elderly people
- Enlarged prostate gland (prostatic hypertrophy)
- People who have recently had a heart attack

Not to be used in
- Breastfeeding
- Children
- Epilepsy
- Mania
- Severe liver disease
Mianserin should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using Mianserin and inform your doctor or pharmacist immediately.
Mianserin should not be used in pregnancy. Seek medical advice from your doctor.
The safety of Mianserin during breastfeeding has not been established. Seek medical advice from your doctor.

Label warnings
Mianserin is to be swallowed whole, not chewed.
Mianserin may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.

Side effects
Possible side effects of Mianserin are as follows:
- Joint pain (arthralgia)
- Seizures (convulsions)
- Decreased production of blood cells by the bone marrow (bone marrow suppression)
- Dizziness
- Excessive fluid retention in the body tissues, resulting in swelling (oedema)
- A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
- A mild degree of mania (hypomania)
- Mild yellowing of the skin and eyes (mild jaundice)
- Breast pain and tenderness or male breast enlargement
- Disturbances of liver function

The side effects listed above may not include all of Mianserin side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with Mianserin, please read the information provided with the medicine or consult your doctor or pharmacist.

Drugs interaction
Mianserin should not be taken with a monoamine oxidase inhibitor (MAOI) antidepressant. Treatment with Mianserin should not be started until 2 weeks after stopping a MAOI.
Mianserin may increase the anti-clotting effect of coumarin anticoagulants such as warfarin. The manufacturer recommends regular blood tests to monitor blood clotting ability.
Mianserin blood levels may be decreased by phenytoin.
Mianserin may increase the sedating effects of alcohol.

Disclaimer
Always read informational leaflet before using medicine! The information can be changed and completed!!

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