Antidepressant therapy with milnacipran and venlafaxine

Lucilla MansuyPierre Fabre M&eacute;dicament, Toulouse, FranceAbstract: Specific serotonin norepinephrine reuptake inhibitors (SNRIs) have been described as &ldquo;better tolerated tricyclic antidepressants&rdquo; or as &ldquo;boosted&rdquo; selective serotoni...

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Autor principal:	Lucilla Mansuy
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/136a4f6bfe8c45a8ae768105802b96ec
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spelling	oai:doaj.org-article:136a4f6bfe8c45a8ae768105802b96ec2021-12-02T06:30:43ZAntidepressant therapy with milnacipran and venlafaxine1176-63281178-2021https://doaj.org/article/136a4f6bfe8c45a8ae768105802b96ec2010-08-01T00:00:00Zhttp://www.dovepress.com/antidepressant-therapy-with-milnacipran-and-venlafaxine-a5111https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Lucilla MansuyPierre Fabre M&eacute;dicament, Toulouse, FranceAbstract: Specific serotonin norepinephrine reuptake inhibitors (SNRIs) have been described as &ldquo;better tolerated tricyclic antidepressants&rdquo; or as &ldquo;boosted&rdquo; selective serotonin reuptake inhibitors (SSRIs). Venlafaxine has become a therapeutic reference treatment for major depression. Although less widely studied, indirect comparisons with another SNRI, milnacipran, suggest an equivalent efficacy. This paper discusses these indirect comparisons and the recently published first double-blind, head-to-head comparison. Venlafaxine has potency at serotonin transporters which is about 30-fold greater than that at norepinephrine transporters while milnacipran has a similar potency at each transporter. Thus, at low doses, venlafaxine acts essentially as a SSRI, with significant noradrenergic activity only occurring at higher doses. To overcome the problem of the differing profile of venlafaxine at increasing doses, the first head-to-head study compared the therapeutic effects and tolerability of the two antidepressants when flexibly titrated to the high dose of 200 mg/day. The study showed that the two SNRIs have similar efficacy and safety profiles. Both drugs produced about 42% remissions at the end of the 20-week study. The most frequent adverse events in both groups were nausea, dizziness, headache, and sweating. Certain specific differences in tolerability are discussed.Keywords: milnacipran, venlafaxine, antidepressant efficacy, tolerability, dose-titration Lucilla MansuyDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2010, Iss Supplement 1, Pp 17-22 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Lucilla Mansuy Antidepressant therapy with milnacipran and venlafaxine
description	Lucilla MansuyPierre Fabre M&eacute;dicament, Toulouse, FranceAbstract: Specific serotonin norepinephrine reuptake inhibitors (SNRIs) have been described as &ldquo;better tolerated tricyclic antidepressants&rdquo; or as &ldquo;boosted&rdquo; selective serotonin reuptake inhibitors (SSRIs). Venlafaxine has become a therapeutic reference treatment for major depression. Although less widely studied, indirect comparisons with another SNRI, milnacipran, suggest an equivalent efficacy. This paper discusses these indirect comparisons and the recently published first double-blind, head-to-head comparison. Venlafaxine has potency at serotonin transporters which is about 30-fold greater than that at norepinephrine transporters while milnacipran has a similar potency at each transporter. Thus, at low doses, venlafaxine acts essentially as a SSRI, with significant noradrenergic activity only occurring at higher doses. To overcome the problem of the differing profile of venlafaxine at increasing doses, the first head-to-head study compared the therapeutic effects and tolerability of the two antidepressants when flexibly titrated to the high dose of 200 mg/day. The study showed that the two SNRIs have similar efficacy and safety profiles. Both drugs produced about 42% remissions at the end of the 20-week study. The most frequent adverse events in both groups were nausea, dizziness, headache, and sweating. Certain specific differences in tolerability are discussed.Keywords: milnacipran, venlafaxine, antidepressant efficacy, tolerability, dose-titration
format	article
author	Lucilla Mansuy
author_facet	Lucilla Mansuy
author_sort	Lucilla Mansuy
title	Antidepressant therapy with milnacipran and venlafaxine
title_short	Antidepressant therapy with milnacipran and venlafaxine
title_full	Antidepressant therapy with milnacipran and venlafaxine
title_fullStr	Antidepressant therapy with milnacipran and venlafaxine
title_full_unstemmed	Antidepressant therapy with milnacipran and venlafaxine
title_sort	antidepressant therapy with milnacipran and venlafaxine
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/136a4f6bfe8c45a8ae768105802b96ec
work_keys_str_mv	AT lucillamansuy antidepressanttherapywithmilnacipranandvenlafaxine
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Antidepressant therapy with milnacipran and venlafaxine

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