title: Milnacipran plasma levels and antidepressant response in Japanese major depressive patients.
abstract: The relationship between antidepressant effects and plasma levels of milnacipran was studied in 49 cases of major depression without psychotic features during 6 weeks of milnacipran treatment. The daily dose of milnacipran was 50 mg/day for the first week, and up to 100 mg/day thereafter. Depressive symptoms were evaluated by the Montgomery and Asberg depression rating scale (MADRS) before treatment and at 1, 2, 4 and 6 weeks after the beginning of this study. Thirty-four patients (69.4%) were responders (defined as a 50% or greater decrease in the baseline MADRS score). Significant differences of MADRS scores were seen from 1 week after the beginning of this study (p=0.004, unpaired t-test) between responders and nonresponders. The mean plasma milnacipran level of responders, 82.0 +/- 29.4 ng/ml, was similar to that of non-responders, 78.6+/-23.1 ng/ml; there was no significant difference between responders and nonresponders. Neither a significant linear nor a curvilinear relationship was obtained between the final MADRS score and the plasma levels of milnacipran. Although there was no significant relationship between the plasma levels of milnacipran and the antidepressant response, milnacipran should be considered an efficacious agent in the treatment of major depressive patients.
authors.affiliation: Omagari City Hospital, 210 Aza Sekihigashi, Iida, Omagari, Akita 014-0067, Japan. higuchi@muj.biglobe.ne.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Higuchi
authors.forename: Keizo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Naito
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamata
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ito
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sato
authors.forename: Kei
authors.initials: K
authors.lastname: Tsukamoto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hishikawa
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002851:Chromatography, High Pressure Liquid; D003521:Cyclopropanes / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors