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 .
Milnacipran efficacy in the prevention of recurrent depression: a 12‐month placebo‐controlled study
& NA ; To compare the efficacy and assess the tolerability of milnacipran 50 mg p.o . b.i.d . to placebo in the prevention of recurrence in depressed patients who had responded an acute treatment and had remained in remission during a 4‐month continuation phase . Remission criteria were : a Hamilton Depression Rating Scale ( HDRS ) ( 21‐item ) ≤ 8 , improvement or disappearance of the initial symptoms , and an assessment of ‘ very much improved ’ or ‘ much improved ’ on the Clinical Global Impression ( CGI ) Subscale : Global Improvement . Recurrence was defined by a major depressive episode according to DSM‐III‐R criteria and a minimum score of 18 on the HDRS , with the need to treat the recurrence . The primary analysis was the rate of recurrence as a function of time in the intent‐to‐treat population . Groups were compared using the Cox model . Absolute recurrence rates were 16.3 % ( 17/104 ) in milnacipran‐treated patients and 23.6 % ( 26/110 ) in placebo‐treated patients , with a significant difference in the reduction of recurrence as a function of time ( Kaplan Meier Survival Analysis analysis , P < 0.05 ) . There was no difference in tolerability between groups . This study demonstrates that milnacipran is effective with good tolerability in preventing recurrence in major depressive disorder over 1 year in patients with recurrent depression who responded to acute treatment with milnacipran and continued their response for 18 weeks
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 .