|
Japanese experience with dual-action antidepressants.
Tajima O.
Department of Mental Health
Kyorin University School of Health Sciences
Hachioji, Tokyo, Japan.
tajimao@kyorin-u.ac.jp
Int Clin Psychopharmacol. 2002 Jun;17 Suppl 1:S37-42.
Abstract
Milnacipran is one of the first modern
antidepressant drugs to be introduced into Japan, and the first
dual-action antidepressant. Placebo-controlled clinical trials with this
drug have demonstrated similar efficacy and superior tolerability to
imipramine and mianserin. The good safety profile of the drug has been
confirmed from open-label phase IV studies. There are indications, both
from the randomized clinical trials and from the phase IV programme, that
milnacipran may have a comparatively rapid onset of action, showing clear
signs of efficacy after one week of treatment. This observation, which
needs to be confirmed in an appropriately designed study, may be the
clinical correlate of the rapid desensitization of 5-hydroxytryptamine
(HT)1A receptors produced by milnacipran. A series of pilot studies have
demonstrated the role of milnacipran in the management of certain
affective disorders not adequately treated by classical antidepressants.
These include bipolar disorder, treatment-resistant depression in the
elderly and post-stroke depression. These findings merit confirmation in
controlled studies, and open the way to using milnacipran to provide
satisfactory treatment of these conditions.
|
