A Double-Blind Multicentre Trial Comparing the Efficacy and Side-Effects of Mianserin and Chlorimipramine in Depressed In- and Outpatients

Abstract

Mianserin (60 mg daily) was compared with chlorimipramine (150 mg daily) in the treatment of 145 depressed in- and outpatients in four centres. The trial was double-blind and fully randomized. Both drugs were effective antidepressants. No significant differences in efficacy could be demonstrated by means of the Hamilton rating scale for depression, the Beck self-rating scale or the clinical global impression, for both in- and outpatients. Hypotension, dry mouth and tremor increased significantly more in inpatients with chlorimipramine than with mianserin. At the end of treatment weight gain was increased significantly more in outpatients after treatment with mianserin. No differences could be demonstrated between the drugs for other side-effects.

Antidepressants of the Serotonin-Antagonist Type Increase Body Fat and Decrease Lifespan of Adult Caenorhabditis elegans

“…Taken together and consistent with the findings in humans in regards to obesity [33], [34], we find that antidepressants of the serotonin antagonist-type do not extend C.elegans lifespan at most commonly used and generally accepted experimental conditions.…”

“…Accordingly, and to test whether solid phase media as used in our C.elegans experiments reflect the situation in humans, we have tried to replicate the fact that mianserin increases human body mass [34] by applying this compound to nematodes. Indeed, both compounds significantly increased body fat after ten days of incubation at the concentrations that have been used by Petrascheck and colleagues [24] (Figs.…”

“…Like numerous other psychoactive compounds, the antidepressant mianserin has been shown to increase appetite [33] as well as body mass [34] in humans. Conversely, obesity has been shown to decrease life span in humans [35] as well as C. elegans [25], while in both species serotonin signalling has been implicated in body fat accumulation [36].…”

Mianserin in the Treatment of Elderly Depressives

“…Besides the antidepressive effects, mianserin also has some anxiolytic features 5 . Various double‐blind studies have demonstrated that mianserin is as effective an antidepressant as imipramine, 6 amitriptyline, 7 or clomipramine, 8 at the same time having a less incidence of anticholinergic side effects 7,9 …”