Mianserin

Mianserin is a tetracyclic antidepressant that has antihistaminic and hypnosedative, but almost no anticholinergic, effect. Mianserin is a weak inhibitor of norepinephrine reuptake and strongly stimulates the release of norepinephrine. Interactions with serotonin receptors in the central nervous system have also been found. Its effect is usually noticeable after one to three weeks. It was previously available internationally, however in most markets it has been phased out in favor of Mirtazapine.

Mianserin blocks inhibitory α2-autoreceptors on central noradrenergic nerve endings, and so may increase the amount of noradrenaline in the synaptic cleft. It may also cause agranulocytosis and aplastic anaemia.