Clinical efficacy of milnacipran: placebo-controlled trials.
The clinical efficacy of milnacipran, a selective serotonin and noradrenaline reuptake inhibitor, was reviewed on the basis of three, multicentre, placebo-controlled trials in major depression. A dose-range study showed the superiority of milnacipran at 50 or 100 mg twice a day compared with placebo whereas the effect of 25 mg twice a day was not clearly distinguished from that of placebo. This has been confirmed by other studies where the 50-mg twice-a-day regimen was shown to be significantly more efficacious than placebo on all outcome measures (Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale, Clinical Global Impression). The positive results in the individual studies were supported by a meta-analysis of the data from the three studies. A subgroup analysis of hospitalized patients in the meta-analysis showed an advantage for milnacipran, suggesting that milnacipran is effective in more severe depression.
Lecrubier
Y
Y
INSERM U302, Hôpital Pitié-Salpetrière, Paris, France.
Pletan
Y
Y
Solles
A
A
Tournoux
A
A
Magne
V
V
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D003521:Cyclopropanes / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D015201:Meta-Analysis as Topic; D000078764:Milnacipran; D015337:Multicenter Studies as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors