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 .
Comparison of efficacy and safety of milnacipran and fluoxetine in Korean patients with major depression
ABSTRACT Object : To compare efficacy and safety of milnacipran and fluoxetine in a population of Korean patients with major depression . Research design and methods : The design was a multi-centre , r and omised , comparative clinical study . Patients with major depression ( DSM‐IV diagnostic criteria ) scoring over 17 points on the 17-item Hamilton Depression Scale ( HAM‐D ) and over 21 points on the Montgomery-Asberg Depression Rating Scale ( MADRS ) were recruited and r and omised to receive milnacipran ( 50 mg/day increasing after 1 week to 100 mg/day ) or fluoxetine ( 20 mg/day ) for 6 weeks . All previous medication was stopped at least 7 days before entry into the study . Patients were evaluated ( HAM‐D , MADRS and clinical global impression scale , CGI ) at baseline and after 1 , 2 , 4 and 6 weeks of treatment . All adverse events which developed during the study period were recorded . Results : 70 patients ( milnacipran 39 ; fluoxetine 31 ) were included in the study . Total score on both HAM‐D , MADRS and CGI decreased significantly in both groups after 1 week and continued to decrease throughout the study . There was no significant difference between the two groups for any measurement at any time point . Both antidepressants were well tolerated . In the milnacipran group , 13 patients reported 28 adverse reactions , and in the fluoxetine group 11 patients reported 18 adverse reactions . Two patients discontinued due to adverse events in the milnacipran group and three in the fluoxetine group . There were no clinical ly significant modifications in vital signs , routine blood laboratory tests , biochemistry or ECG throughout the study . Nausea and headache were the most frequently reported adverse events with milnacipran while digestive disturbances , diarrhoea and insomnia were more common with fluoxetine . Conclusion : Milnacipran , like fluoxetine , was found to be effective and well tolerated for the treatment of major depression in this population of depressed Korean patients . Principal limitations of the study were its open design , its small sample size and its relatively short duration
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 .