There was also some weak evidence to suggest that patients taking milnacipran experienced fewer adverse events of sleepiness/ drowsiness , dry mouth or constipation compared with TCAs .
AUTHORS ' CONCLUSIONS Currently , there is inadequate evidence to conclude whether milnacipran is superior , inferior or the same as other antidepressive agents in terms of efficacy , acceptability and tolerability in the acute phase treatment of major depression .
However , there is some evidence in favour of milnacipran over TCAs in terms of dropouts due to adverse events ( acceptability ) and the rates of experiencing adverse events ( tolerability ) .
Further study is needed to answer whether milnacipran would be the better choice of antidepressant for acute major depression
BACKGROUND Although pharmacological and psychological interventions are both effective for major depression , antidepressant drugs are frequently used as first-line treatment in primary and secondary care setting s. Milnacipran , a dual serotonin-norepinephrine reuptake inhibitor ( SNRI ) , is one of the antidepressant drugs that clinicians use for routine depression care .
OBJECTIVES To assess the evidence for the efficacy , acceptability and tolerability of milnacipran in comparison with tricyclic antidepressants ( TCAs ) , heterocyclics , SSRIs and other newer antidepressive agents in the acute-phase treatment of major depression .
Prevention of recurrent depressive episodes with milnacipran: consequences on quality of life.
BACKGROUND Depression is now seen as a chronic disabling condition that spans the patient 's lifetime and creates significant medical , economic and quality of life consequences . METHODS 500 depressed patients were treated with milnacipran for 6 months . A total of 214 recovered patients were r and omised to receive either milnacipran ( 50 mg bid ) or a matching placebo for a 1-year recurrence prevention phase . Recurrence rate was the primary criteria ; quality of life ( QoL ) consequences were evaluated through a shortened version of the French Sickness Impact Profile ( SIP ) , the Depression Impact Profile ( DIP ) . RESULTS Milnacipran demonstrated its ability to reduce recurrences ( Odds-Ratio=1.5 ; P<0.05 ) , with a more marked effect in recovered patients with few residual symptoms ( Odds-Ratio=3.0 ) . Responders who continued treatment with milnacipran had a dramatic improvement in their quality of life , although patients with residual symptoms still experienced some deterioration in their QoL ( recreation , emotional , social , alertness and home assistance scores ) . Even recovered patients having zero scores on the Hamilton Depression Rating Scale-21 items ( HDRS ) had some QoL deterioration . The DIP emotional score was found to be more predictive of recurrence than the HDRS . Overall , the QoL was improved for those in the milnacipran group in comparison to placebo on the mobility , communication , psycho-social and total scores . LIMITATIONS The QoL evaluation was a secondary criteria ; no a priori sample size estimate was performed . The choice of a generic QoL instrument might have reduced the sensitivity to clinical changes in depression . CONCLUSIONS Prevention of recurrence in MDD with milnacipran contributes to an improvement in the
There was also some weak evidence to suggest that patients taking milnacipran experienced fewer adverse events of sleepiness/ drowsiness , dry mouth or constipation compared with TCAs .
AUTHORS ' CONCLUSIONS Currently , there is inadequate evidence to conclude whether milnacipran is superior , inferior or the same as other antidepressive agents in terms of efficacy , acceptability and tolerability in the acute phase treatment of major depression .
However , there is some evidence in favour of milnacipran over TCAs in terms of dropouts due to adverse events ( acceptability ) and the rates of experiencing adverse events ( tolerability ) .
Further study is needed to answer whether milnacipran would be the better choice of antidepressant for acute major depression
BACKGROUND Although pharmacological and psychological interventions are both effective for major depression , antidepressant drugs are frequently used as first-line treatment in primary and secondary care setting s. Milnacipran , a dual serotonin-norepinephrine reuptake inhibitor ( SNRI ) , is one of the antidepressant drugs that clinicians use for routine depression care .
OBJECTIVES To assess the evidence for the efficacy , acceptability and tolerability of milnacipran in comparison with tricyclic antidepressants ( TCAs ) , heterocyclics , SSRIs and other newer antidepressive agents in the acute-phase treatment of major depression .