title: Psychiatric comorbidities and use of milnacipran in patients with chronic dizziness.
abstract: Psychiatric comorbidities are an important issue in the treatment of chronic dizziness patients.
  
  
  
  To test the correlation between psychiatric status and subjective handicaps and to examine the effects of milnacipran on handicaps.
  
  
  
  Hospital anxiety and depression scale (HADS) and handicaps were assessed by a questionnaire before and eight weeks after milnacipran treatment (50 mg/day) in 29 consecutive patients with chronic dizziness. Effects of milnaciplan were compared with fluvoxamine (200 mg/day).
  
  
  
  A significant correlation was found between anxious and depressive scale scores and also between HADS and handicaps. Duration of symptoms was longer in the anxious/depressive group (HADS≧13) than in the non-anxious/depressive group. Handicaps and HADS were significantly decreased after treatment only in the anxious/depressive group. There were no overall differences in drug effects between milnaciplan and fluvoxamine. However, the rate of patients with a post/pre ratio of handicaps <80% was higher in milnaciplan group compared with the fluvoxamine group.
  
  
  
  Not only anxiety disorders but also depression should be considered as comorbid psychiatric disorders in patients with chronic dizziness. Dizzy patients with psychiatric comorbidities have a longer duration of symptoms and more handicaps than those without psychiatric disorders. Milnacipran may be chosen as a treatment for patients with chronic dizziness with comorbid psychiatric disorders in case of and insufficient response to SSRIs.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Horii
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita City, Osaka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Imai
authors.affiliation: Department of Otolaryngology, Nara Medical University, Shijocho, Kashihara City, Nara, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kitahara
authors.affiliation: Department of Otolaryngology, Osaka General Medical Center, Mandai-higashi, Sumiyoshi-ku, Osaka City, Osaka, Japan.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Uno
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Morita
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita City, Osaka, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D003521:Cyclopropanes / Q000009:adverse effects* / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000523:psychology; D004244:Dizziness / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D000078764:Milnacipran; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D003521:Cyclopropanes; D016666:Fluvoxamine; D000078764:Milnacipran; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Chronic dizziness; SNRI; anxiety; depression; milnacipran