Improvement of the noradrenergic symptom cluster following treatment with milnacipran

Siegfried Kasper, Diana Meshkat, Alexandra KutzelniggDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaAbstract: Depression has a major impact on social functioning. Decreased concentration, mental and physical slowing, loss of energy, lassitude, tiredness, and...

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Autores principales:	Kasper S, Meshkat D, Kutzelnigg A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/871ce0b056224a3e96e20ea2476d4e4c
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spelling	oai:doaj.org-article:871ce0b056224a3e96e20ea2476d4e4c2021-12-02T06:43:46ZImprovement of the noradrenergic symptom cluster following treatment with milnacipran1176-63281178-2021https://doaj.org/article/871ce0b056224a3e96e20ea2476d4e4c2011-05-01T00:00:00Zhttp://www.dovepress.com/improvement-of-the-noradrenergic-symptom-cluster-following-treatment-w-a7568https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Siegfried Kasper, Diana Meshkat, Alexandra KutzelniggDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaAbstract: Depression has a major impact on social functioning. Decreased concentration, mental and physical slowing, loss of energy, lassitude, tiredness, and reduced self-care are all symptoms related to reduced noradrenergic activity. Depressed mood; loss of interest or pleasure; sleep disturbances; and feelings of worthlessness, pessimism, and anxiety are related to reduced activity of both serotonergic and noradrenergic neurotransmission. The importance of noradrenergic neurotransmission in social functioning is supported by studies with the specific norepinephrine reuptake inhibitor reboxetine. In healthy volunteers, reboxetine increases cooperative social behavior and social drive. A placebo-controlled study in depressed patients comparing reboxetine with the selective serotonin reuptake inhibitor (SSRI) fluoxetine showed significantly greater improvement in social adaptation with reboxetine. Two recent studies have examined the effect of the serotonin and norepinephrine reuptake inhibitor milnacipran on social adaptation. A study in depressed patients found that at the end of 8 weeks of treatment with milnacipran, 42.2% patients were in remission on the Social Adaptation Self-evaluation Scale (SASS). Another study in depressed workers or homemakers found that mean depression scores were significantly reduced after 2 weeks, whereas the SASS scores were significantly improved after 4 weeks. A preliminary study comparing depressed patients treated with milnacipran or the SSRI paroxetine showed that milnacipran treatment resulted in a greater number of patients in social remission. The available data thus suggest that milnacipran may improve social functioning, with a possibly greater effect than the SSRI paroxetine. These preliminary data suggest further evaluation of social dysfunction and its treatment outcome in future trials of milnacipran.Keywords: social functioning, Social Adaptation Self-evaluation Scale (SASS), depression, noradrenergic neurotransmission, serotonin and norepinephrine reuptake inhibitors (SNRIs), milnacipranKasper SMeshkat DKutzelnigg ADove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2011, Iss Supplement 1, Pp 21-27 (2011)
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 Kasper S Meshkat D Kutzelnigg A Improvement of the noradrenergic symptom cluster following treatment with milnacipran
description	Siegfried Kasper, Diana Meshkat, Alexandra KutzelniggDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaAbstract: Depression has a major impact on social functioning. Decreased concentration, mental and physical slowing, loss of energy, lassitude, tiredness, and reduced self-care are all symptoms related to reduced noradrenergic activity. Depressed mood; loss of interest or pleasure; sleep disturbances; and feelings of worthlessness, pessimism, and anxiety are related to reduced activity of both serotonergic and noradrenergic neurotransmission. The importance of noradrenergic neurotransmission in social functioning is supported by studies with the specific norepinephrine reuptake inhibitor reboxetine. In healthy volunteers, reboxetine increases cooperative social behavior and social drive. A placebo-controlled study in depressed patients comparing reboxetine with the selective serotonin reuptake inhibitor (SSRI) fluoxetine showed significantly greater improvement in social adaptation with reboxetine. Two recent studies have examined the effect of the serotonin and norepinephrine reuptake inhibitor milnacipran on social adaptation. A study in depressed patients found that at the end of 8 weeks of treatment with milnacipran, 42.2% patients were in remission on the Social Adaptation Self-evaluation Scale (SASS). Another study in depressed workers or homemakers found that mean depression scores were significantly reduced after 2 weeks, whereas the SASS scores were significantly improved after 4 weeks. A preliminary study comparing depressed patients treated with milnacipran or the SSRI paroxetine showed that milnacipran treatment resulted in a greater number of patients in social remission. The available data thus suggest that milnacipran may improve social functioning, with a possibly greater effect than the SSRI paroxetine. These preliminary data suggest further evaluation of social dysfunction and its treatment outcome in future trials of milnacipran.Keywords: social functioning, Social Adaptation Self-evaluation Scale (SASS), depression, noradrenergic neurotransmission, serotonin and norepinephrine reuptake inhibitors (SNRIs), milnacipran
format	article
author	Kasper S Meshkat D Kutzelnigg A
author_facet	Kasper S Meshkat D Kutzelnigg A
author_sort	Kasper S
title	Improvement of the noradrenergic symptom cluster following treatment with milnacipran
title_short	Improvement of the noradrenergic symptom cluster following treatment with milnacipran
title_full	Improvement of the noradrenergic symptom cluster following treatment with milnacipran
title_fullStr	Improvement of the noradrenergic symptom cluster following treatment with milnacipran
title_full_unstemmed	Improvement of the noradrenergic symptom cluster following treatment with milnacipran
title_sort	improvement of the noradrenergic symptom cluster following treatment with milnacipran
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/871ce0b056224a3e96e20ea2476d4e4c
work_keys_str_mv	AT kaspers improvementofthenoradrenergicsymptomclusterfollowingtreatmentwithmilnacipran AT meshkatd improvementofthenoradrenergicsymptomclusterfollowingtreatmentwithmilnacipran AT kutzelnigga improvementofthenoradrenergicsymptomclusterfollowingtreatmentwithmilnacipran
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Improvement of the noradrenergic symptom cluster following treatment with milnacipran

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