Citation

Wistedt B. Nord. J. Psychiatry 1991; 45(S24): 57-59.

Copyright

(Copyright © 1991, Informa - Taylor and Francis Group)

DOI

10.3109/08039489109096682

PMID

unavailable

Abstract

In the present symposium concerning the diagnosis and treatment of depressive syndromes, with a special discussion concerning mianserin, a broad discussion concerning the pharmacologic treatment of depression has been given. In summary, it has been concluded that the tricyclic antidepressants (TCAs) are predominantly of value in so-called typical endogenous depressions, although they may have effects in other forms of depression. There are three important disadvantages: 1) only two-thirds of the patients will respond to the treatment, 2) there are many side-effects, especially anticholinergic side-effects, and 3) there is a considerable acute toxicity in overdose. Today the old irreversible MAO inhibitors have been taken off the market in most countries. Instead, we have got a new series of reversible MAO inhibitors with less severe side-effects and fewer complications. However, the effects seem less promising, especially in atypical depressions. Mianserin seems to induce its effects predominantly through a presynaptic alpha-2-receptor blocking and a blocking of 5-HT1c, 5-HT2 and 5-HT3 receptors. The antidepressive effects seem comparable to those of the TCAs. The acute toxicity is low. During the symposium, the risk of suicide in depressed patients was extensively discussed. Mianserin seems to reduce suicidal thoughts, the acute toxicity is low, and it has been demonstrated quite clearly, e.g. in the Swedish Gotland study, that active pharmacologic treatment of depressions are of great importance in reducing the frequency of suicides. © 1991 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Language: sv

Keywords

human; suicide; Suicide; depression; Antidepressants; conference paper; mianserin; serotonin receptor; side effect; anticholinergic effect