Subjective Side Effects of Mianserin in Relation to Plasma Concentrations of Mianserin and Desmethylmianserin

Otani, Koichi; Sasa, Hiroshi; Higuchi, Hisashi; Kaneko, Sunao; Hishikawa, Yasuo; Fukushima, Yutaka

doi:10.1097/00007691-199206000-00003

Cited by 3 publications

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“…Even the incidence of nausea was not very high, and its development was not dependent on any Css. This result is in line with the results for antidepressants with a low side effect profile, such as mianserin (Otani et al 1992) and trazodone . However, Kasper et al (1993) showed that high Css of FLV were associated with more side effects, e.g.…”

Section: Discussionsupporting

confidence: 90%

Relationship between clinical effects of fluvoxamine and the steady-state plasma concentrations of fluvoxamine and its major metabolite fluvoxamino acid in Japanese depressed patients

et al. 2003

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Section: Discussionsupporting

confidence: 90%

Relationship between clinical effects of fluvoxamine and the steady-state plasma concentrations of fluvoxamine and its major metabolite fluvoxamino acid in Japanese depressed patients

et al. 2003

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Laboratory diagnosis of poisonings

Wennig¹

1996

Human Toxicology

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The CYP2D6 Genotype and Plasma Concentrations of Mianserin Enantiomers in Relation to Therapeutic Response to Mianserin in Depressed Japanese Patients

Mihara

Otani

Tybring

et al. 1997

Journal of Clinical Psychopharmacology

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The relationship between therapeutic response to racemic mianserin and steady-state plasma concentrations of S(+)- and R(-)-mianserin was studied in 26 Japanese patients with major depression. The daily dose of mianserin was 30 mg, and the duration of treatment was 3 weeks. Regarding S-mianserin, the proportion of responders (final Montgomery-Asberg Depression Rating Scale score of 10 or less) was significantly higher in the plasma concentration range of 10 to 23 ng/mL than outside (10 of 11 vs. 3 of 15, p = 0.0005). Such a plasma concentration difference between responders and nonresponders was not found for R-mianserin. In 15 patients, the relationships between the CYP2D6 genotype, determined by allele-specific polymerase chain reaction analysis and Escherichia coli RI restriction fragment length polymorphism, plasma concentrations of the enantiomers, and the therapeutic response were studied. Five patients were homozygous for the wild type (wt) allele (wt/wt), nine were heterozygous for the CYP2D6Ch (Ch) allele causing decreased CYP2D6 activity (Ch/wt), and one patient was heterozygous for the Ch allele and the defect allele CYP2D6D (D) (Ch/D). The Ch/wt group showed significantly higher plasma concentrations of S-mianserin (mean +/- SD: 15 +/- 6 vs. 8 +/- 1 ng/mL, p = 0.007) and proportion of responders (8 of 9 vs. 1 of 5, p = 0.023) than the wt/wt group. The patient with the Ch/D genotype had the highest plasma concentration of S-mianserin (37 ng/mL) and a poor response. No significant relationship was found between the CYP2D6 genotype and plasma concentration of R-mianserin. The study presented here thus suggests that the CYP2D6 genotype plays a major role in controlling plasma concentration of the S-enantiomer of mianserin, which contributes to a major extent to the antidepressant effect during mianserin treatment.

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Subjective Side Effects of Mianserin in Relation to Plasma Concentrations of Mianserin and Desmethylmianserin

Cited by 3 publications

References 0 publications

Relationship between clinical effects of fluvoxamine and the steady-state plasma concentrations of fluvoxamine and its major metabolite fluvoxamino acid in Japanese depressed patients

Relationship between clinical effects of fluvoxamine and the steady-state plasma concentrations of fluvoxamine and its major metabolite fluvoxamino acid in Japanese depressed patients

Laboratory diagnosis of poisonings

The CYP2D6 Genotype and Plasma Concentrations of Mianserin Enantiomers in Relation to Therapeutic Response to Mianserin in Depressed Japanese Patients

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