title: Therapeutic effects of milnacipran, a serotonin and noradrenaline reuptake inhibitor, on post-stroke depression.
abstract: Depression is common after stroke. While several reports have been published on the use of antidepressants such as selective serotonin reuptake inhibitors and tricyclics for the treatment of post-stroke depression (PSD), no previous study has examined the use of a selective serotonin and noradrenaline reuptake inhibitor (SNRI) for this condition. The present study investigated the efficacy and safety of milnacipran, a SNRI, for the treatment of PSD. A 6-week open study was conducted in 12 patients (two males and 10 females) aged 53-88 years. All patients were diagnosed with major or minor depressive disorder according to DSM-IV, where onset was subsequent to a cerebral infarction or haemorrhage (stroke). Severity of depression was assessed using the 21-item Hamilton rating scale for depression (HAM-D). The maximum total daily dose of milnacipran was in the range of 30-75 mg b.i.d. Three patients experienced side-effects, but none of the side-effects were serious. Two patients dropped out of the study. At the end of the study, 58.3% (7/12) of the total patient population and 70% (7/10) of the patients completing the study were in remission (a final HAM-D score of less than 7 and no longer meeting criteria for major or minor depression). These results suggest that milnacipran may be an effective treatment for PSD.
authors: Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan. mkimura@med.email.ne.jp
authors: M
authors: M
authors: Kimura
authors: K
authors: K
authors: Kanetani
authors: R
authors: R
authors: Imai
authors: H
authors: H
authors: Suzuki
authors: K
authors: K
authors: Isayama
authors: S
authors: S
authors: Endo
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D003521:Cyclopropanes / Q000009:adverse effects / Q000494:pharmacology*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors