A patient with depression and insomnia. When should you consider mianserin? Review article
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Abstract
Sleep disorders occur in most patients with depression and not only impair quality of life but also increase the risk of persistent symptoms, relapses, and poorer response to treatment. In patients who, despite SSRI therapy, experience persistent insomnia, anxiety, and incomplete clinical improvement, combination therapy with mianserin is worth considering. Due to its different mechanism of action, this drug improves sleep quality, exhibits anxiolytic properties, and may increase the effectiveness of antidepressant treatment. Studies indicate that adding mianserin to SSRIs promotes greater reduction in depressive symptoms, especially insomnia, anxiety, and psychomotor retardation. Mianserin is not addictive like traditional sleep medications, but its use requires individualization due to the possibility of drowsiness, increased appetite, and weight gain. A particularly beneficial solution may be the addition of small doses of mianserin in the evening in patients with depression associated with persistent sleep disorders.
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