Milnacipran, a new serotonin and noradrenaline reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability
Puech A, Montgomery SA,
Prost JF, Solles A, Briley M
Groupe Hospitalier Pitie-Salpetriere,
Paris, France.
Int Clin Psychopharmacol 1997 Mar; 12(2):99-108


Milnacipran (Ixel) is a new antidepressant with essentially equal potency for inhibiting the reuptake of both serotonin and noradrenaline, with no affinity for any neurotransmitter receptor studied. A review of the studies comparing milnacipran, placebo and active comparator antidepressants provides clear-cut evidence of its efficacy in both severe and moderate depression in hospitalized and community settings. Meta-analyses of the original data of controlled trials involving 1032 patients, comparing milnacipran with imipramine or selective serotonin reuptake inhibitors (SSRIs), show that milnacipran provides antidepressant efficacy similar to that of imipramine and significantly superior to that of the SSRIs. An analysis of a database of over 3300 patients shows that both the general and cardiovascular tolerability of milnacipran are superior to those of the tricyclic antidepressants (TCAs) with fewer cholinergic side-effects. The tolerability of milnacipran was comparable to that of the SSRIs, with a higher incidence of dysuria with milnacipran, and a higher frequency of nausea and anxiety with the SSRIs. Milnacipran is a new therapeutic option in depression, which offers a clinical efficacy in the range of the TCAs combined with a tolerability equivalent to that of the SSRIs.
Milnacipran v imipramine
Milnacipran and cognition
Antidepressant metabolism
Antidepressant mechanisms
Milnacipran (Ixel) : structure
Milnacipran versus fluvoxamine
Milnacipran and the dopamine system
Milnacipran for post-stroke depression
Milnacipran for depression after brain injury
Milnacipran (Ixel): beyond a role of antidepressant
Milnacipran (Ixel): dosage and antidepressant response
Cabergoline plus milnacipram (Ixel) for refractory depression

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family