title: Evaluation of the neurological safety of epidural milnacipran in rats.
abstract: BACKGROUND
  Milnacipran is a balanced serotonin norepinephrine reuptake inhibitor with minimal side effects and broad safety margin. It acts primarily on the descending inhibitory pain pathway in brain and spinal cord. In many animal studies, intrathecal administration of milnacipran is effective in neuropathic pain management. However, there is no study for the neurological safety of milnacipran when it is administered neuraxially. This study examined the neurotoxicity of epidural milnacipran by observing behavioral and sensory-motor changes with histopathological examinations of spinal cords in rats.
  
  
  METHODS
  Sixty rats were divided into 3 groups, with each group receiving epidural administration of either 0.3 ml (3 mg) of milnacipran (group M, n = 20), 0.3 ml of 40% alcohol (group A, n = 20), or 0.3 ml of normal saline (group S, n = 20).
  
  
  RESULTS
  There were no abnormal changes in the behavioral, sensory-motor, or histopathological findings in all rats of groups M and S over a 3-week observation period, whereas all rats in group A had abnormal changes.
  
  
  CONCLUSIONS
  Based on these findings, the direct epidural administration of milnacipran in rats did not present any evidence of neurotoxicity in behavioral, sensory-motor and histopathological evaluations.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Seung Mo
authors.initials: SM
authors.lastname: Lim
authors.forename: Mee Ran
authors.initials: MR
authors.lastname: Shin
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Kang
authors.forename: Hyun
authors.initials: H
authors.lastname: Kang
authors.forename: Francis Sahngun
authors.initials: FS
authors.lastname: Nahm
authors.forename: Baek Hui
authors.initials: BH
authors.lastname: Kim
authors.forename: Hwa Yong
authors.initials: HY
authors.lastname: Shin
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Sang Chul
authors.initials: SC
authors.lastname: Lee
keywords: epidural injection; milnacipran; neurotoxicity