title: Milnacipran for neuropathic pain in adults.
abstract: BACKGROUND
  Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is sometimes used to treat chronic neuropathic pain and fibromyalgia. This is an update of an earlier review of milnacipran for neuropathic pain and fibromyalgia in adults originally published in The Cochrane Library Issue 3, 2012. We split that review so that this one looked only at neuropathic pain, and a separate review looks at fibromyalgia.
  
  
  OBJECTIVE
  To assess the analgesic efficacy and associated adverse events of milnacipran for chronic neuropathic pain in adults.
  
  
  METHODS
  We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to 23 February 2015, together with reference lists of retrieved papers and reviews.
  
  
  METHODS
  We included randomised, double-blind studies of eight weeks' duration or longer, comparing milnacipran with placebo or another active treatment in chronic neuropathic pain.
  
  
  METHODS
  Two review authors independently searched for studies, extracted efficacy and adverse event data, and examined issues of study quality. We did not carry out any analysis.
  
  
  RESULTS
  We included a single study of 40 participants with chronic low back pain with a neuropathic component. It found no difference in pain scores between milnacipran 100 mg to 200 mg daily or placebo after six weeks (very low quality evidence). Adverse event rates were similar between treatments, with too few data to draw conclusions (very low quality evidence).
  
  
  CONCLUSIONS
  There was no evidence to support the use of milnacipran to treat neuropathic pain conditions.
authors.affiliation: Pain Research and Nuffield Department of Clinical Neurosciences (Nuffield Division of Anaesthetics), University of Oxford, Pain Research Unit, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
authors.forename: Sheena
authors.initials: S
authors.lastname: Derry
authors.forename: Tudor
authors.initials: T
authors.lastname: Phillips
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Moore
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Wiffen
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D001416:Back Pain / Q000188:drug therapy*; D059350:Chronic Pain / Q000188:drug therapy*; D003521:Cyclopropanes / Q000008:administration & dosage* / Q000009:adverse effects; D005356:Fibromyalgia / Q000188:drug therapy; D006801:Humans; D000078764:Milnacipran; D009437:Neuralgia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000700:Analgesics; D003521:Cyclopropanes; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors