AbstractIn the psychopharmacological treatment of depression in cancer patients, mianserin appears to have advantages over other antidepressants. However, it is, claimed to be associated with an unacceptably high incidence of neutropenia. This claim was assessed by investigating the frequency of reported cases of mianserin‐related neutropenia against the estimated prescription figures in South Africa. Simultaneously, a more specific assessment was carried out in the form of a 10‐year retrospective analysis of all patients presenting with neutropenia to the Department of Haematology, Groote Schuur Hospital, South Africa. Ten patients (18% of the total) demonstrated a psychotropic drug‐related neutropenia, and in no instance could mianserin be incriminated. The haematological lesion reversed upon withdrawal of the drug in eight out of these patients as opposed to 12 out of 22 in the non‐drug‐related, idiopathic group. It would appear that the incidence of mianserin‐related neutropenia is no higher than with other psychotropic drugs and, similarly, the condition is reversible. It is concluded that mianserin would therefore be an appropriate first‐line agent in the treatment of depress
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