Depression and anxiety: mianserin and nomifensine compared in a double-blind multicentre trial

Mianserin and nomifensine were compared in 61 depressive patients in a randomized double-blind multicentre study. During the first week the antidepressant dosages were low, mianserin 30 mg and nomifensine 50 mg. After the first week dosages were doubled to 60 mg and 100 mg respectively. At baseline there were no significant differences between treatment groups for sex, age, class of depression, previous treatment, somatic symptoms, previous vital events, global clinical appreciation, global sleep appreciation, and depression assessed on the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS) or the Hamilton Anxiety Rating Scale (HARS). Assessments were made at 7, 14 and 28 days. There were no significant differences between treatment groups for HDRS, MADRS or HARS, either globally or when divided into endogenous and reactive subgroups. Compared with nomifensine there were significantly greater scores with mianserin for global clinical appreciation and global sleep appreciation. There were more withdrawals and dosage changes with nomifensine than with mianserin. Regarding concomitant treatment, significantly less anxiolytics were prescribed to the mianserin group. This study confirms that mianserin is an effective and sedative antidepressant whereas nomifensine is an effective and stimulating antidepressant.