Mianserin and blood dyscrasias

1 The haematological side-effects of mianserin have been studied. 2 There are 26 reported cases, of which 19 appear to show a definite association with the drug. A high proportion are female. 3 A reversible agranulocytosis has been most commonly observed, occurring between four and six weeks of treatment. On cessation of therapy, the counts have recovered. 4 Three patients have died, following a longer course of treatment. Two of these were septicaemic and the third, thrombocytopenic in addition. This is probably related to a failure of marrow recovery owing to the longer exposure, in the third case progressing to aplasia. 5 The number of reported dyscrasias is extremely small compared with the number of courses of mianserin prescribed. 6 It is desirable that a blood examination should be made at four weeks after starting treatment with mianserin to identify those patients at risk.