title: Response rate obtained using milnacipran depending on the severity of depression in the treatment of major depressive patients.
abstract: Milnacipran--a new specific serotonin and noradrenaline reuptake inhibitor--is as effective as tricyclic antidepressants and exhibits a higher remission rate for major depressive patients than selective serotonin reuptake inhibitors. However, the effectiveness of milnacipran for severe major depressive patients had not been studied adequately. The study included 96 Japanese patients who fulfilled the DSM-IV criteria for the diagnosis of major depressive disorders and whose score on the Montgomery-Asberg Depression Rating Scale (MADRS) was 21 or higher. Of these, 16 patients were excluded because 10 did not complete the study, and 6 showed poor compliance. Finally, 80 patients were included. We defined patients with a baseline MADRS score of > or = 31 points as "severe" (n = 25). The remaining patients were classified as "moderate" (31 > MADRS score > or = 25, n = 30) and "mild" (MADRS score < 25, n = 25) using the median score of those patients as the cutoff. Milnacipran was administered twice daily for 6 weeks. The initial total dose was 50 mg/d; after a week it was increased to 100 mg/d. The response rates were 72%, 70%, and 44% in the "severe," "moderate," and "mild," respectively. No significant differences were found between "severe" and the "moderate"; however, significant differences were observed between "severe" and "mild" and "moderate" and "mild." These results demonstrated that milnacipran is almost equally effective in "severe" and "moderate." This study suggested that milnacipran has a reliable antidepressant effect in treating severe and moderate major depressive patients.
authors.affiliation: Department of Psychiatry, Akita University School of Medicine, Akita, Japan. yuka@psy.med.akita-u.ac.jp
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sugawara
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: Mitsuhiro
authors.initials: M
authors.lastname: Kamata
authors.forename: Shingo
authors.initials: S
authors.lastname: Naito
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sato
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000097:blood / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000097:blood / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000097:blood / Q000145:classification* / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran