R. Marshall
Apr 1, 1983
Citations
1
Influential Citations
41
Citations
Journal
British journal of clinical pharmacology
Abstract
Since its introduction into clinical medicine, mianserin hydrochloride has been shown to be a potent and useful treatment for depressive illness and seems to offer real advantages over the established tricyclic antidepressants in terms of fewer side-effects, lack of cardiotoxicity and greater safety in overdosage. In the proceedings of the last mianserin symposium published in this journal (Peet & Turner, 1978), the pharmacology of mianserin pertaining to its mode of action was succinctly reviewed in eight pages and pointed to the atypical pharmacological profile of the drug in the standard battery of pharmacological tests for predicting antidepressant activity (Table 1). Since then several comprehensive reviews on possible mechanisms underlying antidepressant activity have appeared (Sulser, 1979; Kostowski, 1981; Maj, 1981; Waldmeier, 1981) and an excellent review of the pharmacology of mianserin published (van Riezen et al., 1981). The medicinal chemical design of potential antidepressant agents has for many years been dictated (some might even say hampered) by the 'biogenic amine hypotheses' [see Waldmeier (1981) for a recent review] which broadly state that certain types of depression are associated with (or are due to) deficient noradrenergic and/or serotoninergic neurotransmission in certain areas of the brain. These views have been rigorously challenged or modified over the last few years, partly on the grounds that chronic treatment of animals with clinically-active antidepressants produces quite different biochemical and pharmacological effects from those seen after acute dosing (e.g., U'Prichard et al., 1978; Maj, 1981; Sugrue, 1981). In addition a wealth of evidence suggests that mechanisms other than neuronal amine re-uptake inhibition may be