Cardiac effects of mianserin: results of clinical pharmacological investigations

Summary

The tetracyclic antidepressant mianserin was tested for cardiac effects in two clinical pharmacological trials. In one study, mianserin was compared with amitriptyline and with a placebo in 18 healthy young volunteers in a double-blind, randomized, group-comparative trial stratified for sex. In the second study, two different therapeutic doses of mianserin (30 mg or 60 mg/day) were given to 50 patients suffering from cardiovascular diseases, such as myocardial infarction, cardiac failure and coronary heart disease. Treatment of the healthy volunteers lasted 8 days, the heart patients were treated for 3 consecutive weeks. A significant prolongation of the pre-ejection period was found in the healthy males receiving amitriptyline; this indicates a negative effect on myocardial contractility. In the same trial, a reduction in the left ventricular end-systolic volume, possibly through increasing the ejection fraction, was observed in the mianserin-treated subjects; this suggests a favourable effect on cardiac performance. These observations support the assumption that therapeutic doses of a tricyclic antidepressant may produce unwanted cardiac effects whereas mianserin seems devoid of cardiotoxicity. The lack of any drug effect of either dose of mianserin in heart patients in the second study indicates that individuals with cardiovascular diseases apparently are at no greater risk when treated with the antidepressant mianserin.

Key Words::

• Mianserin
• amitriptyline
• antidepressive agents
• heart function tests