The pharmacokinetics of mianserin in elderly depressed patients

doi:10.1016/0165-1781(83)90016-1

Psychiatry Research

Volume 8, Issue 4, April 1983, Pages 281-287

https://doi.org/10.1016/0165-1781(83)90016-1 Get rights and content

Abstract

The pharmacokinetics of mianserin were examined in eight elderly depressed patients following a single oral dose of 60 mg. Plasma concentrations were measured by gas chromatography / mass spectrometry and the data analyzed using a two-compartment open model. Mean (± SD) estimates were: absorption half-life 0.8 ± 1.0h, peak concentration 117 ± 23 μg/1, peak time 2.2 ± 1.3h, distribution half-life 3.4 ± 1.2h, elimination half-life 33 ± 15h, apparent volume of distribution 20.2 ± 7.91/kg, and oral clearance 0.49 ± 0.211/kg/h. These parameters were not significantly different from those found in healthy volunteers. The absorption lag time (0.6 ± 0.2h) and area under the curve (2009 ± 566μg/1/h) were significantly different in the elderly. The clinical implications of these differences for the treatment of elderly depressed patients are discussed.

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There are more references available in the full text version of this article.

Cited by (9)

Serum mianserin and ageing
1994, Progress in Neuropsychopharmacology and Biological Psychiatry
- 1.
  1. Mianserin is a tetracyclic antidepressant with relatively few anticholinergic and cardiovascular sideeffects. Its clinical efficacy is comparable to that of tricyclic antidepressants. It is widely used in Europe, especially in elderly outpatients.
- 2.
  2. In the present studies, the authors have evaluated the efficacy of mianserin as well as the effects of ageing and concomitant psychotropic drugs on serum mianserin concentrations in 169 depressive psychiatric inpatients.
- 3.
  3. In the patients the mean serum mianserin concentrations or their interindividual variations did not differ between the old, middle-aged, and young age groups. Furthermore, elderly women and men did not differ from each other for their dose-related drug concentrations. Neither were any differences found in serum mianserin concentrations between the older (≥75 years) and younger elderly (65–74). As is the case with TCAs, the co-administration of neuroleptics increased serum mianserin concentrations in the elderly. When comparing the therapeutic response and serum mianserin concentrations the authors found that the patients with good clinical improvement had higher mean serum mianserin concentrations than those without efficacy.
- 4.
  4. There seem to be no clinically important changes in the phannacokinetics of mianserin with advancing age. The present results do not support the claim that the therapeutic profile of this drug is altered with advancing age. Mianserin can be regarded as an antidepressant with relatively few side-effects in the elderly.
Pharmacokinetic aspects of antidepressant treatment in the elderly
1993, Progress in Neuropsychopharmacology and Biological Psychiatry
- 1.
  1. Physiological and metabolic changes with ageing may affect the pharmacokinetics of antidepressant drugs.
- 2.
  2. Pharmacokinetic parameters following single doses of antidepressants in the elderly tend to be altered compared with younger subjects.
- 3.
  3. Elimination half-life tends to be prolonged for most antidepressant drugs in the elderly due to decreased clearance and increased volume of distribution.
- 4.
  4. Steady-state plasma concentrations tend to be increased in elderly patients.
- 5.
  5. Inter-individual differences usually account for the majority of the variance in kinetic parameters rather than an effect of ageing per se.
- 6.
  6. The increased propensity for side effects in the elderly is probably due to pharmacodynamic rather than pharmacokinetic alterations with age.
Antidepressant Treatment of Very Old Patients
1993, American Journal of Geriatric Psychiatry
Most studies of the elderly use age 65 as the definition of the onset of old age, and most studies of the pharmacologic treatment of depression in the elderly focus on patients between the ages of 60 and 70. Very few patients over the age of 75 have been specifically studied, and virtually none over the age of 80. Data for this review of treatment of depressed patients over the age of 75 were derived from a larger review prepared for a 1992 NIMH consensus development conference on the diagnosis and treatment of depression in late life. Available studies were divided into three categories: 1) mixed-age studies that include subjects over 75 (n = 18); 2) mixed-age reports of patients having a mean age of 75 or older (n = 13); and 3) reports including only patients with minimum age of 75 years or older (>n = 5). Data are available from only 171 identifiable patients over the age of 75. Consequently, available data for patients in this very old age category are too limited for reliable or valid treatment recommendations to be made; further research is necessary.
Inhibition of cardiac hERG potassium channels by tetracyclic antidepressant mianserin
2008, Naunyn-Schmiedeberg's Archives of Pharmacology
Moclobemide pharmacokinetics in depressed patients: Lack of age effect
1991, Human Psychopharmacology: Clinical and Experimental
Serum mianserin concentrations in psychiatric inpatients of different ages
1991, Acta Psychiatrica Scandinavica

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The pharmacokinetics of mianserin in elderly depressed patients

Abstract

Contribution to Workshop on Clinical Pharmacology and Efficacy of Mianserin

British Journal of Clinical Pharmacology

Age related change in the pharmacokinetics of some psychotropic drugs and its clinical implications

Contribution to the Workshop on Clinical Pharmacology and Efficacy of Mianserin

British Journal of Clinical Pharmacology

A pharmacokinetic study of mianserin

European Journal of Clinical Pharmacology