The effect of mianserin in chronic idiopathic abdominal pain A pilot study

Mianserin is a tetracyclic antidepressant that has gained popularity in Europe owing to lack of anticholinergic side effects and good tolerability. Being a histamine-1 and -2 receptor antagonist and an alpha-2 receptor blocker suggests that it should be of particular value in somatoform gastrointestinal disorders. In an open trial mianserin was given for 6 weeks to 24 patients with chronic idiopathic abdominal pain of more than 2 years' duration. Patients with a diagnosis of depressive or anxiety disorders were excluded. Daily dosage varied from 90 to 120 mg. Other psychopharmacologic or analgesic medication was not allowed during the trial. Pain response was measured by means of the Clinical Global Improvement Scale and daily self-reporting. Five patients dropped out. Of 19 completers, 15 reported significantly reduced pain. Placebo-controlled studies are needed to validate these encouraging results.