Lerivon is an antidepressant from the group of piperazine-azepine compounds that are not chemically related to tricyclic antidepressants.
Release form and composition
Lerivon is produced in the form of tablets: oblong, biconvex, coated in white, with a cross-line and a code on the front side, labeled “Organon” on the second side (10 or 20 pieces in blister packs, in a cardboard bundle respectively 2 or 1 package).
Ingredients 1 tablet:
- Active ingredient: mianserin hydrochloride - 30 mg;
- Auxiliary components: magnesium stearate, methyl hydroxypropyl cellulose, colloidal silicon dioxide, methyl cellulose, polyethylene glycol, calcium hydrogen phosphate, potato starch, titanium oxide.
Indications for use
Lerivon is used to treat depressive conditions of various genesis.
- Acute period of myocardial infarction;
- Severe abnormal liver function;
- Manic syndrome;
- Age up to 18 years;
With caution, the drug is used in the following cases:
- Chronic heart failure;
- Renal or hepatic impairment;
- Hypertrophy of the prostate gland;
- Angle-closure glaucoma;
Dosing and Administration
Lerivon should be taken orally, swallowing the pill whole, not chewed, sipped with water if necessary. It is preferable to take the entire dose in one dose at night, but it can be divided into several doses.
The doctor determines the dose and duration of treatment in each case individually.
The recommended starting dose for adults is 30 mg / day. If necessary, every few days this dose is increased to obtain the necessary clinical response. The average effective dose is usually 60-90 mg / day.
Treatment of elderly people also begin with a daily dose of 30 mg, then gradually increase, but for this category of patients the effective maintenance dose may be somewhat lower.
In the case of a properly selected dose 2-4 weeks after the start of treatment, a positive response to the therapy should be noted. In case of insufficient efficacy, the dose may be increased. If after 2-4 weeks there is no response to treatment, the drug is withdrawn.
After the achieved clinical improvement, the intake of Lerivon is continued for 4-6 months.
Patients suffering from depression show symptoms directly related to this disease, therefore in some cases it is difficult to determine which of them are a consequence of a depressive state and which are due to Lerivon's use.
Possible side effects:
- Blood and lymphatic system: rarely - agranulocytosis or granulocytopenia;
- Metabolism and nutrition: often - weight gain;
- Mind: rarely - hypomania;
- Nervous system: often - a sedative effect that usually occurs at the beginning of treatment and decreases as the treatment continues (reducing the dose does not lead to a decrease in sedation, but increases the danger with regard to antidepressant efficacy); rarely, hyperkinesis (including restless legs syndrome), convulsions, neuroleptic malignant syndrome;
- Cardiovascular system: infrequently - arterial hypotension; rarely bradycardia after taking the initial dose;
- Hepato-biliary disorders: often: increased activity of liver enzymes; rarely jaundice;
- Skin and subcutaneous tissue: Infrequently - rash;
- Musculoskeletal system: infrequently - arthralgia;
- Other: often - swelling.
* classification of the frequency of side effects: often - more than 1%, rarely - 0.1-1%, rarely - less than 0.1%.
In very rare cases, with abrupt cessation of treatment may develop withdrawal syndrome.
Symptoms of an acute overdose of mianserin hydrochloride are usually limited to an increase in the duration of the sedative effect. In rare cases, convulsions, cardiac arrhythmia, severe hypotension, respiratory depression. There is no specific antidote. Treatment of overdose involves gastric lavage, conducting symptomatic and supportive therapy in relation to the vital functions of the body.
Depression is always associated with an increased risk of self-harm, suicidal thoughts and suicide. This danger persists until significant remission occurs. Considering that there may be no improvement in the first few weeks of treatment, patients should be monitored continuously until clinical improvement occurs. Young people and patients with suicidal gestures in history, who prior to the start of treatment showed a high degree of suicidal imagination, are at greater risk of suicide. Patients and relatives themselves, who take care of them, should be warned about the need to immediately consult a doctor in case of suicidal thoughts.
In the case of jaundice, convulsive reactions or hypomania states Lerivon should be canceled.
After 4-6 weeks after the start of treatment, there is a likelihood of agranulocytosis and granulocytopenia, so if you experience stomatitis, pharyngitis, fever, or other signs of an infectious disease, you must pass a blood test.
Patients undergoing treatment with Lerivon are advised to refrain from controlling vehicles and performing types of work that require speed of reaction and increased attention, especially at first.
When taking the drug should not drink alcoholic beverages.
It is forbidden to administer Lerivone simultaneously with monoamine oxidase inhibitors and for 14 days after their cancellation.
Although mianserin hydrochloride does not interact with propranolol, clonidine, betanidin, methyldopa, guanethidine (including in combination with hydralazine), it is recommended to control blood pressure if you need to combine Lerivone with antihypertensive drugs.
Mianserin hydrochloride may interfere with the metabolism of coumarin derivatives (including warfarin), so control is necessary.
Lerivon enhances the inhibitory effect of ethanol on the central nervous system.
Terms and conditions of storage
Store at a temperature of 2 to 30 ºC in a dry, dark place and out of reach of children.
Shelf life - 5 years.