title: Augmentation of milnacipran by risperidone in treatment for major depression.
abstract: Milnacipran, one of the serotonin noradrenaline reuptake inhibitors (SNRIs) to which venlafaxine and duloxetine belong, is a new antidepressant that has recently become available in many countries. Despite the advances in pharmacotherapy, almost one third of patients with depressive illness respond inadequately to monotherapy with such an antidepressant. We herein describe five patients with major depression who responded partially, but not fully, to milnacipran alone and remarkably improved with an adjunct of risperidone. In addition, milnacipran plus risperidone was found to be a useful augmentation for treatment-refractory depression in 3 of the 5 patients. The minimum dose of risperidone, 0.5 or 1 mg/d, was efficacious. The time of response after addition of risperidone was within 4 d. Our experience suggests that an augmentation therapy of milnacipran plus risperidone is useful for treating patients with depression who only partially respond to various types of antidepressants and for treatment-refractory depression.
authors.affiliation: Department of Psychiatry and Neurology, Hamamatsu University School of Medicine, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tani
authors.forename: Nori
authors.initials: N
authors.lastname: Takei
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kawai
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Sekine
authors.forename: Takao
authors.initials: T
authors.lastname: Toyoda
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Minabe
authors.forename: Norio
authors.initials: N
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D003521:Cyclopropanes; D000078764:Milnacipran; D018967:Risperidone