Toxic and sometimes fatal reactions (similar to or the same as serotonin
syndrome) have very occasionally occurred in patients taking both
MAOIs and tricyclic antidepressants. Case reports suggest that
mianserin can interact similarly.
Avoid concurrent use.
Mianserin should not be started for 2 weeks after treatment with
MAOIs has been stopped and an MAOI should not be started until at least 7 to 14 days after
mianserin has been stopped. If concurrent use is thought necessary it has been suggested that it should only be undertaken by those well aware of the problems and who can undertake adequate supervision.