Recurrent ventricular fibrillation in mianserin intoxication

[Depression therapy for somatic diseases]

A review of works devoted to the problem of psychopharmacotherapy of depression in general medical practice is presented. The issues of its comorbidity with somatic and neurological diseases, as well as multimorbidity are discussed. Both direct and side-effects of antidepressants, which are important for effective therapy of not only affective disorders proper, but also the symptoms of the leading pathology, are considered in detail for individual organs and systems. The analysis of the preferred pharmacological classes of antidepressants, which are drugs of first choice, taking into account the somatic condition of the patient, is carried out, and drugs are indicated, the appointment of which is undesirable for the treatment of a patient with a certain disease. The presented results are aimed both at increasing the efficiency of therapy for patients with general medical level of health care, and at increasing the safety of treatment of psychiatric patients with concomitant somatic disorders.

Bradycardia and hypotension in mianserin intoxication

Cardiotoxicity is an important adverse effect of tricyclic antidepressants. But cardiac side effects after intoxication with the tetracyclic mianserin are rare. In this paper, we describe a case in which bradycardia and hypotension occured due to mianserin overdose. A 37-year-old woman was admitted to the medical intensive care unit for self-poisoning with 30 tablets of 10 mg mianserin 2 hours before her admission. The patient denied taking any other drugs. Four hours after her admission, bradycardia and hypotension occurred and she began to suffer from giddiness. Atropine and theophylline were given. On the second and third day, her heart rate and blood pressure were normal. Based on this case, we estimate the probability of bradycardia and hypotension in mianserin intoxication and the significance of closely monitoring the patient.

Mianserin and Ventricular Tachycardia: Case Report and Review of the Literature

Mianserin is a drug frequently used to treat depression and sleep disturbances. Despite documented effects on various cardiac tissues in animal studies, mianserin has a very safe clinical profile. Only one case of ventricular arrhythmias in a patient treated with mianserin has been reported. This patient had a severe cardiac history. Our case is to our knowledge the first report on ventricular arrhythmias in a patient treated with mianserin without previous or present cardiac disease. After discontinuation of mianserin the arrhythmias disappeared within days. The literature on mianserin toxicity is reviewed.

Sensitive determination of mianserin and setiptiline in body fluids by gas chromatography with surface ionization detection (GC-SID)

Tetracyclic antidepressants, mianserin and setiptiline, in human body fluids have been found measurable with high sensitivity by gas chromatography (GC) with surface ionization detection (SID). The compounds in human whole blood or urine samples were extracted by solid-phase extraction using Bond Elut C(18) cartridges. The recoveries of both compounds from the body fluids were above 85%. For quantitation of mianserin, 25 ng of setiptiline was used as internal standard; and for quantitation of setiptiline, vice versa. The calibration curves for spiked whole blood or urine samples were linear in the range of 1.25-50 ng/ml. The detection limit of mianserin and setiptiline was about 1 ng/ml, which is comparable to those obtained by the previous GC-mass spectrometry methods. Our method seems very useful for determination of mianserin and setiptiline in forensic and clinical toxicology, because of high sensitivity, low background impurities and easy handling of the GC instrument.