[Depressed patients and their treatment. Therapeutic mistakes and toxicity (author's transl)]

Prescribing tricyclic antidepressants presents potential hazards to patients with heart disease, glaucoma, prostatic hypertrophy and epilepsy for their symptoms may be aggravated. Mianserin, on the other hand, has little effect on the heart and the parasympathetic nervous system and this drug may be used safely in these circumstances. Tricyclic antidepressants and mianserin also differ in their toxicity when taken in overdose. Poisoning with mianserin rarely causes more than drowsiness except when other drugs have been taken. In contrast overdose with tricyclic antidepressants frequently causes epileptic convulsions, arhythmias, hypotension, and anticholinergic signs. Death occurs in 2-3% of overdoses, usually due to cardiovascular collapse, respiratory depression or status epileptic's either alone or in combination.