[Mianserin in acute cardiopathies. 27 cases recorded in a medical intensive care unit].

The cardiovascular tolerance of mianserin, a tetracyclic antidepressant with anxiolytic properties, at a dose of 30 to 90 mg/day, is studied in 27 patients affected by acute cardiopathies and attended for two months by a cardiologist and a psychiatrist. From the cardiovascular point of view progression is as usual, with two deaths from recurrence of a massive infarct, prognosis in agreement with the literature. A clinical examination, the electrocardiogram and Holter monitoring did not reveal any side effects. Psychiatric progression is favourable, in conformity with studies of the antidepressive and anxiolytic properties of mianserin. These results are compared with those of tricyclic antidepressants usually employed up to now in similar cases, with their well-known cardiovascular risks, particularly in the case of an overdose. The authors thus suggest the use of mianserin in the acute phase of all cardiopathies, in cases of depression and/or anxiety, because it is efficacious and well-tolerated, whereas a tricyclic antidepressant would not be easy to handle, dangerous, indeed formally contra-indicated. By extension, they suggest its use in chronic cardiopathies.