A comparative study of milnacipran and paroxetine in outpatients with major depression.
BACKGROUND
Milnacipran is a dual-action antidepressant which inhibits both serotonin and noradrenaline reuptake with no affinity for any neurotransmitter receptor studied.


METHODS
A 6-week double-blind multicentre study compared milnacipran (100 mg/day) with paroxetine (20 mg/day) in 300 outpatients with major depression. Efficacy was evaluated using HAMD17, MADRS and CGI for severity of illness and global improvement. Data were analysed on an intention to treat, last observation carried forward, basis.


RESULTS
Milnacipran and paroxetine were both effective and well tolerated with no significant difference in their effects. After treatment discontinuation, milnacipran was associated with significantly less emergent symptoms. Responders, at endpoint, to milnacipran had significantly greater levels of psychomotor retardation at baseline than non-responders.


CONCLUSIONS
The study did not include a placebo group so that it is impossible to determine absolute levels of efficacy.


CONCLUSIONS
Both milnacipran and paroxetine were effective and well tolerated by outpatients with major depression treated for 6 weeks. After treatment discontinuation milnacipran was associated with less emergent symptoms. Psychomotor retardation at baseline may be a predictive factor of a favourable response to milnacipran.
Sechter
Daniel
D
Service de Psychiatrie de l'Adulte, Centre Hospitalier Universitaire St Jacques, Besançon, Cedex F-25030, France. daniel.sechter@ufc-chu.univ-fcomte.fr
Vandel
Pierre
P
Weiller
Emmanuel
E
Pezous
Nicole
N
Cabanac
Fabienne
F
Tournoux
Alain
A
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D011930:Reaction Time / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors