Mianserin may potentiate CNS-depressant action of alcohol (alcohol intake should be avoided during treatment). Mianserin, like other antidepressants, may precipitate hypomania in susceptible subjects with bipolar depressive illness. In such a case treatment with mianserin should be withdrawn. Suicide-related behaviors (suicide attempt and suicidal thoughts), and hostility (predominantly aggression, oppositional behavior and anger) more frequently observed in clinical trials among children and adolescents treated with antidepressants compared to those treated with placebo. Patients with major depressive disorder may experience worsening of depression and/or emergence of suicidal ideation and behavior (suicidality). The following symptoms reported in patients being treated with antidepressants for major depressive disorder as well as for other indications: anxiety, agitation, panic attacks, insomnia, irritability, hostility (aggressiveness), impulsivity, akathisia (psychomotor restlessness), hypomania and mania. When treating patients with diabetes or cardiac, hepatic or renal insufficiency, normal precautions should be exercised and dosages of any concomitant therapy kept under review. Patients with narrow-angle glaucoma or symptoms suggestive of prostatic hypertrophy should also be monitored even though anticholinergic side-effects not anticipated with mianserin therapy. Sedation might occur at initiation of treatment and decrease as treatment continues.