Levomilnacipran for the treatment of major depressive disorder: a review

Gregory M Asnis,1,2 Margaret A Henderson21Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 2Anxiety and Depression Clinic, Montefiore Medical Center, Bronx, New York, NY, USAAbstract: Levomilnacipran (LVM, Fetzima®) was recently approved by the US Food...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Asnis GA, Henderson MA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f0ffd2f25ebe43cfaecbe3b12fb54c10
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f0ffd2f25ebe43cfaecbe3b12fb54c10
record_format	dspace
spelling	oai:doaj.org-article:f0ffd2f25ebe43cfaecbe3b12fb54c102021-12-02T05:52:04ZLevomilnacipran for the treatment of major depressive disorder: a review1178-2021https://doaj.org/article/f0ffd2f25ebe43cfaecbe3b12fb54c102015-01-01T00:00:00Zhttp://www.dovepress.com/levomilnacipran-for-the-treatment-of-major-depressive-disorder-a-revie-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Gregory M Asnis,1,2 Margaret A Henderson21Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 2Anxiety and Depression Clinic, Montefiore Medical Center, Bronx, New York, NY, USAAbstract: Levomilnacipran (LVM, Fetzima®) was recently approved by the US Food and Drug Administration for the treatment of major depressive disorder. It is a unique dual neurotransmitter reuptake inhibitor. In contrast with other selective serotonin norepinephrine reuptake inhibitors, including duloxetine, venlafaxine, and desvenlafaxine, it has greater selectivity for inhibiting norepinephrine reuptake than serotonin reuptake. Our review focuses on the efficacy, safety, and tolerability data for five double-blind, placebo-controlled, short-term studies and two long-term studies. In the short-term studies, LVM was found to be more effective than placebo in reducing depression (Montgomery-Åsberg Depression Rating Scale) scores as well as improving functional impairment (Sheehan Disability Scale) scores. Long-term studies found LVM to be similarly effective but in the only placebo-controlled long-term study, LVM was not significantly superior to placebo. LVM is fairly well tolerated, with the most common adverse events being nausea, headache, dry mouth, hyperhidrosis, and constipation. Discontinuation rates were mildly increased in those being treated with LVM (9%) versus placebo (3%). Adverse events were not dose-related except for urinary hesitancy and erectile dysfunction. LVM was weight neutral, was not toxic to the liver, and did not cause clinically significant QTc prolongation. Consistent with being a predominant potentiator of norepinephrine, pulse and blood pressure were significantly elevated by LVM but rarely induced tachycardia or hypertension. LVM is a relatively safe alternative antidepressant treatment with minimal drug–drug interactions. It is the only antidepressant that has in its labeling that it is not only effective in improving depression but also effective in improving impaired functioning. Whether this important effect on functioning is unique to LVM must be researched. In addition, whether LVM might be effective in norepinephrine-deficit depression, refractory depression, atypical depression, or seasonal depression is yet to be evaluated. Ultimately, head-to-head studies comparing LVM with other antidepressants will determine the place of LM in antidepressant treatment.Keywords: levomilnacipran, antidepressant, clinical efficacy, functional impairmentAsnis GAHenderson MADove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 125-135 (2015)
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 Asnis GA Henderson MA Levomilnacipran for the treatment of major depressive disorder: a review
description	Gregory M Asnis,1,2 Margaret A Henderson21Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 2Anxiety and Depression Clinic, Montefiore Medical Center, Bronx, New York, NY, USAAbstract: Levomilnacipran (LVM, Fetzima®) was recently approved by the US Food and Drug Administration for the treatment of major depressive disorder. It is a unique dual neurotransmitter reuptake inhibitor. In contrast with other selective serotonin norepinephrine reuptake inhibitors, including duloxetine, venlafaxine, and desvenlafaxine, it has greater selectivity for inhibiting norepinephrine reuptake than serotonin reuptake. Our review focuses on the efficacy, safety, and tolerability data for five double-blind, placebo-controlled, short-term studies and two long-term studies. In the short-term studies, LVM was found to be more effective than placebo in reducing depression (Montgomery-Åsberg Depression Rating Scale) scores as well as improving functional impairment (Sheehan Disability Scale) scores. Long-term studies found LVM to be similarly effective but in the only placebo-controlled long-term study, LVM was not significantly superior to placebo. LVM is fairly well tolerated, with the most common adverse events being nausea, headache, dry mouth, hyperhidrosis, and constipation. Discontinuation rates were mildly increased in those being treated with LVM (9%) versus placebo (3%). Adverse events were not dose-related except for urinary hesitancy and erectile dysfunction. LVM was weight neutral, was not toxic to the liver, and did not cause clinically significant QTc prolongation. Consistent with being a predominant potentiator of norepinephrine, pulse and blood pressure were significantly elevated by LVM but rarely induced tachycardia or hypertension. LVM is a relatively safe alternative antidepressant treatment with minimal drug–drug interactions. It is the only antidepressant that has in its labeling that it is not only effective in improving depression but also effective in improving impaired functioning. Whether this important effect on functioning is unique to LVM must be researched. In addition, whether LVM might be effective in norepinephrine-deficit depression, refractory depression, atypical depression, or seasonal depression is yet to be evaluated. Ultimately, head-to-head studies comparing LVM with other antidepressants will determine the place of LM in antidepressant treatment.Keywords: levomilnacipran, antidepressant, clinical efficacy, functional impairment
format	article
author	Asnis GA Henderson MA
author_facet	Asnis GA Henderson MA
author_sort	Asnis GA
title	Levomilnacipran for the treatment of major depressive disorder: a review
title_short	Levomilnacipran for the treatment of major depressive disorder: a review
title_full	Levomilnacipran for the treatment of major depressive disorder: a review
title_fullStr	Levomilnacipran for the treatment of major depressive disorder: a review
title_full_unstemmed	Levomilnacipran for the treatment of major depressive disorder: a review
title_sort	levomilnacipran for the treatment of major depressive disorder: a review
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/f0ffd2f25ebe43cfaecbe3b12fb54c10
work_keys_str_mv	AT asnisga levomilnacipranforthetreatmentofmajordepressivedisorderareview AT hendersonma levomilnacipranforthetreatmentofmajordepressivedisorderareview
_version_	1718400208651419648

Levomilnacipran for the treatment of major depressive disorder: a review

Ejemplares similares