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 .
Controlled comparison of two doses of milnacipran (F 2207) and amitriptyline in major depressive inpatients
A multicenter study compared the antidepressant efficacy and the tolerance of two doses of milnacipran ( 50 mg and 100 mg/day ) and amitriptyline ( 150 mg/day ) in three parallel groups of 45 major depressive in patients defined by Research Diagnostic Criteria . After a wash-out period of 4–7 days on placebo with lorazepam and /or nitrazepam if necessary , patients were r and omly assigned to a daily dose of milnacipran 50 mg , milnacipran 100 mg or amitriptyline 150 mg reached on the 5th day and then stable over a 4-week period , with weekly assessment s by means of the Montgomery and Asberg depression scale , the Hamilton depression scale , the Clinical Global Impressions ( CGI ) and the Target Emergent Signs and Symptoms . Results showed significant superiority of both milnacipran 100 mg/day and amitriptyline over milnacipran 50 mg/day at the end of the treatment period . However , amitriptyline induced a nonsignificant trend toward more rapid improvement after 2 weeks of treatment , mainly based on items related to insomnia , supporting more sedative properties of amitriptyline as compared to milnacipran . Anticholinergic side-effects were significantly lower with milnacipran than with amitriptyline , explaining why milnacipran 100 mg exhibited at the end of the treatment period , a nonsignificantly better efficacy index on the CGI . Moreover , in contrast to milnacipran , amitriptyline was responsible for a significant decrease in blood pressure and a significant weight gain
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 .