Mianserin added to tricyclic antidepressants in depressed patients not responding to a tricyclic antidepressant alone: A randomized, placebo-controlled, double-blind study

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Abstract
The purpose of this study was to investigate whether depressed patients not responding to tricyclic antidepressants (TCA) would respond on addition of 30–60 mg mianserin. Thirty-seven in- and out-patients still fulfilling DSM-HI criteria for a major depressive episode after at least 4 weeks of treatment with 150 mg TCA were randomly allocated to two groups receiving in addition either mianserin or placebo. The study was conducted double-blind and lasted for 3 weeks. There was a significantly better improvement in the mianserin-TCA group than in the placebo-TCA group after 3 weeks of treatment as measured on the Montgomery-Åsberg's Depression Scale and the Global Assessment Scale. There were no differences in side effects between the two groups. Three patients did not complete the study. Our data indicate that mianserin may be added to a tricyclic antidepressant in non-responders with improved antidepressive effect and that this is a safe strategy for augmentation therapy with regard to side effects.