Another common first line drug option for the treatment of depression are Tetracyclic Antidepressants, such as Mianserin. These drugs prevent neurotransmitters from interacting with nerve cell receptors.  This indirectly increases the levels of neurotransmitters and serotonin in the brain.

Common side effects may include:

Drowsiness

Weight gain

Dry mouth

Dizziness

Light headedness

Thirst

Muscle aches

Constipation

Increased appetite

Increased cholesterol

Flu like symptoms

Signs of infection