Antidepressant efficacy and tolerability of milnacipran, a dual serotonin and noradrenaline reuptake inhibitor: a comparison with fluvoxamine
by
Clerc G; Milnacipran/Fluvoxamine Study Group.
Centre Hospitalier Specialise,
Pontorson, France.
Int Clin Psychopharmacol 2001 May; 16(3):145-51


ABSTRACT

The antidepressant efficacy and tolerability of milnacipran, a dual action serotonin-noradrenaline reuptake inhibitor, were compared with those of the selective serotonin reuptake inhibitor, fluvoxamine, in 113 patients with moderate to severe major depression. Treatment with milnacipran, 50 mg b.d. for 6 weeks, produced a significantly greater reduction in Montgomery-Asberg Depression Rating Scale (MADRS) scores than fluvoxamine, 100 mg b.d. (P = 0.007; 65.4% versus 49.9%, respectively); significantly greater decreases were also seen on days 7 (P = 0.04) and 28 (P = 0.03). The response rate (the proportion of patients showing a decrease in MADRS scores of at least 50%) was 78.9% in patients receiving milnacipran, compared with 60.7% in fluvoxamine-treated patients (P = 0.04). Milnacipran also produced greater improvements in 24-item Hamilton Depression Rating Scale scores (P = 0.05). On the Clinical Global Impression Improvement scale, 77.2% of milnacipran-treated patients were rated as considerably or markedly improved, compared with 60.7% of patients receiving fluvoxamine (P = 0.06 chi-squared). Both treatments were well tolerated; the only significant difference between the two groups was a higher incidence of tremor and drowsiness in patients treated with fluvoxamine. It is concluded that milnacipran may offer some advantages over selective serotonin reuptake inhibitors, such as fluvoxamine, in the treatment of moderate to severe major depression.
SSRIs
Options
Duloxetine
Nefazodone
Mirtazapine
Venlafaxine
Milnacipran
Fluvoxamine
Milnacipran: structure
Milnacipran v imipramine
Milnacipran and cognition
Antidepressant metabolism
Antidepressant mechanisms
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


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