title: Effectiveness of milnacipran for the treatment of chronic pain: a case series.
abstract: Milnacipran is a novel serotonin noradrenaline reuptake inhibitor. The authors describe the use of milnacipran for the treatment of chronic pain in a series of patients. There were 5 outpatients who suffered chronic pain for at least 3 months. None of these patients met the DSM-IV criteria for a major depressive disorder. Chronic pain was assessed clinically by means of a visual analog scale (VAS) before and 12 weeks after the start of the milnacipran treatment or at the time the drug was stopped. The duration of pain was 17.8 +/- 9.3 months (mean +/- SD), and the baseline VAS score was 88.2 +/- 6.3 points. Milnacipran was administered at 50 to 150 mg/day, and the dose at 12 weeks or at the time the drug was stopped was 85.0 +/- 31.3 mg/day. The mean +/- SD decrease in VAS at this time was 61.2 +/- 15.5%. Three patients showed marked improvement (decrease in VAS, >75%). Their decreases in VAS scores were 86.5%, 85.7%, and 77.6%. One patient showed mild improvement (42.0% decrease in VAS). These 4 patients tolerated the drug well. The fifth patient experienced nausea and discontinued treatment after 4 weeks. The VAS decrease for this patient was 14.3%. Results of this study show milnacipran to be beneficial in patients with chronic pain. This drug should be studied further for its effectiveness in the treatment of chronic pain.
authors.affiliation: Department of Psychiatry, Yuri Kumiai General Hospital, Honjo City, Japan. m.kamata@yuri-hospital.honjo.akita.jp
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Naito
authors.forename: Hisashi
authors.initials: H
authors.lastname: Higuchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003521:Cyclopropanes / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D009325:Nausea / Q000139:chemically induced; D014179:Neurotransmitter Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D010147:Pain Measurement
chemical_list: D003521:Cyclopropanes; D014179:Neurotransmitter Uptake Inhibitors; D000078764:Milnacipran