title: Milnacipran dose-effect study in patients with burning mouth syndrome.
abstract: OBJECTIVE
  The object of this study was to evaluate the dose-dependent efficacy and tolerability of milnacipran in patients with burning mouth syndrome (BMS) with inadequate response at low doses.
  
  
  METHODS
  A 12-week open-label dose-escalation study was conducted in 56 female patients (aged 20-83 years, with a mean age of 60.8 years). The initial dosage of milnacipran was 30 mg/d, and the dosage was raised up to 60 mg and 90 mg/d every 4 weeks until an improvement of at least 50% reduction of visual analog scale was achieved.
  
  
  RESULTS
  The mean ± SD effective daily dose of milnacipran was 63.9 ±16.7 mg. The cumulative improvement rate for the daily dose of 30 mg was 28.6%, and this rate rose (50.8%-67.9%) as the daily dose was increased (from 60 to 90 mg, respectively). The cumulative proportion of responders was significantly greater, with maximal daily doses of 60 and 90 mg, compared with that of 30 mg (P < 0.05, χ test). Most adverse events appeared at the low dose, and there was little evidence for dose-dependence of adverse effects. No serious safety issues were observed.
  
  
  CONCLUSIONS
  From the result of this study, dose escalation of milnacipran for patients with burning mouth syndrome with inadequate response at low doses may be helpful if the 30-mg daily dose has been tolerated well.
authors: Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. ykato.ompm@tmd.ac.jp
authors: Yuichi
authors: Y
authors: Kato
authors: Tomoko
authors: T
authors: Sato
authors: Ayano
authors: A
authors: Katagiri
authors: Yojiro
authors: Y
authors: Umezaki
authors: Miho
authors: M
authors: Takenoshita
authors: Tatsuya
authors: T
authors: Yoshikawa
authors: Yusuke
authors: Y
authors: Sato
authors: Akira
authors: A
authors: Toyofuku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002054:Burning Mouth Syndrome / Q000188:drug therapy*; D003521:Cyclopropanes / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008875:Middle Aged; D000078764:Milnacipran; D014179:Neurotransmitter Uptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009638:Norepinephrine / Q000037:antagonists & inhibitors / Q000502:physiology; D010147:Pain Measurement; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003521:Cyclopropanes; D000078764:Milnacipran; D014179:Neurotransmitter Uptake Inhibitors; D009638:Norepinephrine; D017367:Selective Serotonin Reuptake Inhibitors