HAMD, Hamilton Rating Scale for Depression; MADRS, Montgomery and Åsberg Depression Rating Scale; ITT, intent-to-treat; … In a study by Ansseau et al,30 milnacipran was prescribed at a dose of 50 or 100 mg/day, with a third group receiving amitriptyline 150 mg/day. At the end of 4 weeks at fixed doses, milnacipran 100 mg/day was as effective as amitriptyline 150 mg/day on change in mean scores on the Inhibitors,research,lifescience,medical HAMD 24 items and MADRS
with time, in the 109 patients who were treated for the whole period (completer cases). The authors concluded that milnacipran 100 mg/day was more effective than 50 mg/day, but statistical analysis was not in favor of this conclusion. In a dose-ranging study by Ansseau et al,33 the dose-response at fixed doses could only be evaluated for the first 2 weeks. On visual inspection of the figures in the publication,33 there were no differences between milnacipran 200 and 300 mg/day and Inhibitors,research,lifescience,medical fluvoxamine 200 mg/day on change in mean scores on the HAMD 24 items and MADRS with time. Lecrubier et
al31 described a study with three dosages of milnacipran 50, 100, and 200 mg/day. At the end of 8 weeks, in a total of 412 patients, milnacipran 100 mg/day, but not 50 or 200 mg/day, was more effective than placebo on change on the HAMD 17 items total score; milnacipran 100 and 200 mg/day, but not 50 mg/day, was superior to placebo on change in MADRS total score. There was no statistical analysis between Inhibitors,research,lifescience,medical the three doses of milnacipran, but inspection of data in the publication31 suggests that milnacipran 100 and 200 mg/day were superior to 50 mg/day, and that there was no difference between them. The percentage Inhibitors,research,lifescience,medical of responded, for a total of 412 patients, were 48%, 65%, and 53% in milnacipran 50-, 100-, and I-BET151 chemical structure 200-mg/day groups, Inhibitors,research,lifescience,medical respectively, compared with 44% in placebo group on the HAMD; the difference was only significant between milnacipran 100 mg/day and placebo.
In the study by Guelfi et al,32 milnacipran was prescribed at doses of 100 and 200 mg/day, with a third group receiving fluoxetine 20 mg/day. At the end of 12 weeks, there were no differences between the three groups on change on the HAMD 17 items and MADRS total scores on ITTLOCF. Per protocol analysis, ie, 237 patients who completed at least a 14 day treatment period, showed no differences between unless the three groups on change on the HAMD and MADRS total scores at the end of 12 weeks. The responders rate were 62%, 54%, and 51% on HAMD, and 64%, 55%, and 49% on MADRS in milnacipran 100 and 200 mg/day, and fluoxetine 20 mg/day groups, respectively on ITT-LOCF; the difference was only significant between milnacipran 100 mg/day and fluoxetine 20 mg/day on the MADRS. Venlafaxine In the venlafaxine studies, doses varied between 25 and 375 mg/day (Table III). A positive dose-response curve was only demonstrated with trend analysis. However, the difference between the higher dose range and placebo was not pronounced.