A four-week randomized multicentre study comparing mianserin and melitracen-flupentixol was conducted in 90 outpatients suffering from depressive anxiety states with a predominantly psychosomatic symptomatology. Both patient groups showed a favourable clinical response to treatment as well as a good tolerance. No significant differences were observed in the drop-out rates or in the incidence of side-effects, although drowsiness tended to develop more frequently during the first days of mianserin treatment. The improvement scores of the groups showed that mianserin has significant advantages when depressed mood, sleep disturbances and autonomic disregulations predominate the depressive anxiety state.