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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.
Abstract
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
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