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Lerivon is an antidepressant with a sedative component. The active substance of Lerivon - mianserin - belongs to the group of piperazine-azepine compounds (truly tetracyclic), which distinguishes the drug from tricyclic antidepressants. In the chemical structure of Lerivon there is no side chain, which determines the anticholinergic effect of tricyclic antidepressants. In terms of antidepressant activity, the efficacy of Lerivon is comparable with other modern antidepressants. At the same time, its peculiarity is anxiolytic effect and a positive effect on sleep.
Depressive syndrome of various genesis requiring pharmacotherapy.
One coated tablet contains: Mianserin hydrochloride 30 mg.
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Dosage and Administration
The dosage regimen is set individually and adjusted in the course of treatment, depending on the response of the patient. Adults are prescribed in an initial daily dose of 30-45 mg. Effective therapeutic dose ranges from 30-90 mg / day. The daily dose can be divided into several doses or, preferably, administered once a night (given the positive effect on sleep). It is advisable to continue antidepressant therapy for a few more months after the clinical effect is achieved. For elderly patients, doses are adjusted individually, starting at 30 mg / day. Then the daily dose may be gradually increased. The maintenance effective dose may be slightly lower than for middle-aged patients. For use in children there are no recommendations because of the limited experience of the clinical use of the drug in this category of patients.
Patients with depression show a number of symptoms directly related to the disease itself (dry mouth, persistent constipation, accommodation disturbances). Therefore, it is sometimes difficult to determine which symptoms result from the disease, and which results from treatment with Lerivon.
|Class system organ||Calculated frequency of adverse effects|
|Often (> 1%)||Infrequently (0.1-1%)||Rarely (<0.1%)|
|Blood and lymphatic system disorders||Granulocytopenia or agranulocytosis|
|Metabolism and nutrition disorders||Weight gain|
|Nervous system disorders||Sedation that occurs at the beginning of treatment and diminishes with continued treatment (N.B. dose reduction usually does not reduce sedation, but there is a danger regarding antidepressant efficacy)||Cramps
Hyperkinesis (including restless legs syndrome)
Neuroleptic Malignant Syndrome
|Heart disorders||Bradycardia after the initial dose|
|Hepato-biliary disorders||Increased liver enzymes||Jaundice|
|Violations of the skin and subcutaneous tissue||Exanthema|
|Musculoskeletal, connective tissue and bone disorders||Arthralgia|
- Manic syndrome.
- Severe abnormal liver function.
Lerivon does not change the body's response to the on / in the introduction of pressore amines of norepinephrine (norepinephrine) and tyramine. Lerivon does not affect the antihypertensive effects of propranolol (alone or in combination with hydralazine, guanethidine or betanidin). Lerivon does not affect the severity of the hypotensive effect of clonidine and methyldopa, either during one-time or long-term use. No clinically significant interaction of Lerivon with the anticoagulant Fenprocumone was observed. Adverse interaction of Lerivon with MAO inhibitors cannot be ruled out; therefore, the administration of MAO inhibitors should be stopped at least 14 days before the prescription of Lerivon.
Pregnancy and Lactation
The use of Lerivon during pregnancy is possible only if absolutely necessary.
It is necessary to observe the usual caution when prescribing Lerivon to patients with diabetes mellitus (some patients may require correction of hypoglycemic therapy), patients with diseases of the cardiovascular system, renal and hepatic failure. In the process of treatment with Lerivon, one should refrain from drinking alcohol due to the potentiation of the latter’s action on the central nervous system. A study of the pattern of peripheral blood is indicated in patients who have a rise in temperature, a sore throat, or signs of any infection during the treatment with Lerivon. Due to the absence of an anticholinergic action, the drug can be used in patients with prostate adenoma, glaucoma, and gastrointestinal dysfunction, but such patients require observation.Older patients and patients with cardiovascular diseases, as a rule, tolerate Lerivon well. In elderly patients, the use of Lerivon usually does not lead to the development of confusion. Patients taking Lerivon should refrain from potentially hazardous activities that require increased attention and quickness of psychomotor reactions (especially in the first few days of therapy).
When patients received Lerivon in a single dose of 1 g or more (for suicidal purposes), suchthe symptoms, as pronounced drowsiness, increased blood pressure, in rare cases - arterial hypotension, sinus tachycardia or bradycardia, vomiting, dizziness, ataxia. There were no cases of seizures, arrhythmias, coma.
Treatment: after ingestion of a toxic dose of Lerivon, gastric lavage should be performed for 2 hours, and measures should be taken to maintain the function of the cardiovascular system. Hemodialysis and hemoperfusion are not recommended.
- Brand name: Lerivon
- Active ingredient: Mianserin
- Dosage form: Pills
- Manufacturer: Schering-Plough
- Country of Origin: USA
- Modulation by Mianserin Pretreatment of the Chronic Electroconvulsive Shock Effects on the Adrenergic System in the Cerebral Cortex of the Rat
- Double-Blind Randomized Controlled Pilot Study of the Efficacy and Tolerability of Pirlindole, a Reversible Inhibitor of Monoamine Oxidase A, and Mianserin, in the Treatment of Depression
- Mianserin suppositories in the treatment of post-operative delirium
- Effects of nocturnal doses of mirtazapine and mianserin on sleep and on daytime psychomotor and driving performance in young, healthy volunteers
- A randomised, double-blind comparison of the efficacy and safety of citalopram compared to mianserin in elderly, depressed patients with or without mild to moderate dementia
- The serotonin antagonist mianserin improves functional recovery following experimental spinal trauma
- Pharmacology of [3H]mianserin binding in the nerve cord of the American cockroach, Periplaneta americana
- Determination of the enantiomers of mianserin, desmethylmianserin, and 8-hydroxymianserin in the plasma and urine of mianserin-treated patients
- Mianserin-induced 5-HT2 receptor downregulation results in anxiolytic effects in the elevated plus-maze test
- A sequential double-blind controlled study of moclobemide and mianserin in elderly depressed patients
- Antidepressant therapeutic effect of mianserin-induced generalized tonic-clonic seizure in an elderly patient
- Comparison of mianserin and dothiepin treatment on the serotonergic system in depressed patients
- Is there a therapeutic window for plasma concentration of mianserin plus desmethylmianserin?
- Autoradiographic distribution of cholinergic muscarinic receptors and serotonin2 receptors in olfactory bulbectomized (OB) rats after chronic treatment with mianserin and desipramine
- The effect of mianserin hydrochloride on delirium
- Crossover reaction between mianserin and trazodone for restless legs syndrome
- The efficiency of a carbamazepine–mianserin combination scheme in opiate detoxification
- Tritiation of mianserin
- Synthesis of [N-methyl-11C]mianserin: a tetracyclic, atypical antidepressant
- Determination of mianserin and metabolites in plasma by liquid chromatography with electrochemical detection
- Successful treatment of fluoxetine-indueed dystonia with low-dose mianserin
- High-performance liquid chromatographic determination of mianserin in plasma and brain and its application to pharmacokinetic studies in the rat
- Automated high-performance liquid chromatographic method for the determination of mianserin in plasma using electrochemical detection
- Liquid chromatographic determination of mianserin in plasma by fluorescence detection after on-line photochemical reaction