Remission rates with milnacipran 100 mg/day and 150 mg/day in the long-term treatment of major depression.
BACKGROUND
The aim of this study was to determine remission rates during treatment with two different dosages of milnacipran, and the effect of milnacipran therapy for at least 1 year on the maintenance of remission and tolerability, in outpatients with major depression.


METHODS
The study included 41 outpatients with major depression who initially received milnacipran 50 mg/day for 1-2 weeks, followed by a dosage increase to 100 mg/day for 12 weeks. Patients who achieved remission (17-item Hamilton Depression Rating Scale [HDRS] scores <or=7) after 12 weeks of milnacipran 100 mg/day treatment continued at the same dosage and were followed for at least 1 year. For patients who had decreased HDRS scores, but failed to attain remission, the dosage of milnacipran was increased to 150 mg/day, and those who achieved remission were then followed for at least 1 year.


RESULTS
Eight out of 41 patients were withdrawn from the study prematurely because of adverse events (eight events in six patients: nausea, thirst, urinary discomfort, rapid pulse, palpitations, staggering sensation or sweating) or as a result of the patient's decision (two patients). Thirteen (31.7%) of 41 patients achieved remission during treatment with milnacipran 100 mg/day. Of the remaining 20 patients, 17 underwent a dosage increase to 150 mg/day, and 13 achieved remission at a second assessment (cumulative remission rate: 63.4%). No adverse events or recurrence of symptoms were found in any of the patients who achieved remission during the subsequent follow-up period of a minimum of 1 year.


CONCLUSIONS
The results of this study showed milnacipran 150 mg/day and 100 mg/day to be effective and well tolerated in the long-term treatment of outpatients with major depression, and indicated that a dosage of 150 mg/day is an effective therapeutic option for depression when a dosage of 100 mg/day does not provide a satisfactory response.
Okumura
Kazuo
K
Department of Neuropsychiatry, Tenri Hospital, Nara, Japan. okazuo@tenriyorozu-hp.or.jp
Furukawa
Toshiaki A
TA
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003521:Cyclopropanes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors