title: Usefulness of milnacipran in treating phantom limb pain.
abstract: BACKGROUND
  Amputation of an extremity often results in the sensation of a "phantom limb" where the patient feels that the limb that has been amputated is still present. This is frequently accompanied by "phantom limb pain". We report here the use of milnacipran, a serotonin and norepinephrine reuptake inhibitor, to treat phantom limb pain after amputation of injured or diseased limbs in three patients.
  
  
  RESULTS
  The severity of phantom pain before and during treatment was quantified using a visual analog scale. In one case, phantom limb pain responded partially to treatment with high doses of paroxetine, and then replacement with milnacipran further improved the pain relief and long-term full pain relief was achieved. In the two other cases, milnacipran was used as first-line treatment and phantom limb pain responded rapidly.
  
  
  CONCLUSIONS
  These results suggest that milnacipran administration may be useful in phantom limb pain, possibly as a first-line treatment.
authors.affiliation: Department of Psychiatry (Psychosomatic Medicine), Kyoto First Red Cross Hospital, Kyoto, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Nagoshi
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Saiko
authors.initials: S
authors.lastname: Inoue
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kuroda
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukui