Effects of milnacipran: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia (FM). 2 A number of studies have explored the mechanisms by which milnacipran reduces FM symptoms. Research using functional magnetic resonance imaging (fMRI) suggests that milnacipran may change pain sensitivity by altering activity in specific brain regions involved in pain processing. 2 Additionally, milnacipran has demonstrated pain-reducing effects in a rat model of postoperative pain, increasing serotonin and norepinephrine levels in the spinal cord. 15 These findings suggest that milnacipran might reduce FM pain by modulating pain signaling and decreasing pain sensitivity.

Some research indicates that milnacipran may also improve cognitive function, particularly flexibility. 9 Furthermore, milnacipran has shown potential benefit in treating neuropathic pain caused by chemotherapy drugs like paclitaxel and vincristine. 8 、 7 These studies suggest that milnacipran may reduce neuropathic pain by affecting specific receptors involved in the development of neuropathic pain.

Benefits and Risks

Benefit Summary

Milnacipran may be effective in reducing FM symptoms, particularly pain. 2 、 4 Milnacipran may also have benefits for other pain conditions, including postoperative pain, neuropathic pain, and depression. 15 、 9 、 8 、 7 、 19 Some studies suggest that milnacipran may improve cognitive function, particularly flexibility. 9

Risk Summary

The most common side effect of milnacipran is nausea. 2 Milnacipran can also affect the electrical activity of the heart, so caution is advised for those with heart disease or those at risk for heart disease. 16 Other side effects include headache, dizziness, drowsiness, dry mouth, constipation, and sexual dysfunction. 2 、 19 Milnacipran can interact with other medications, so it's important to talk to your doctor if you are taking any other medications.

Comparison Across Studies

Study Similarities

These studies suggest that milnacipran is a promising drug for the treatment of various pain conditions, including fibromyalgia, postoperative pain, neuropathic pain, and depression. 2 、 15 、 9 、 8 、 7 、 19 These studies suggest that milnacipran may reduce pain by inhibiting the reuptake of serotonin and norepinephrine. 15 、 8 、 7 Furthermore, these studies suggest that milnacipran may reduce pain by modulating pain signaling and decreasing pain sensitivity. 2 、 15 、 9 、 8 、 7 、 19 However, the effects of milnacipran vary across individual studies, and further research is needed to fully understand its efficacy and safety.

Study Differences

These studies suggest that milnacipran may have different effects on different pain conditions. 2 、 15 、 9 、 8 、 7 、 19 The side effects of milnacipran also vary across individual studies. 2 、 16 、 19 Therefore, more research is needed to determine whether milnacipran is the right medication for a particular individual.

Consistency and Contradictions in Findings

Research on the effects of milnacipran shows consistent results, however, further study is needed to determine precisely how milnacipran works and which types of pain it is most effective for. 2 、 15 、 9 、 8 、 7 、 19 Regarding side effects, some studies suggest that milnacipran may affect the electrical activity of the heart, while other studies have not shown such effects. 16 These inconsistencies require further investigation.

Real-World Application Considerations

Milnacipran may be effective in reducing FM symptoms, particularly pain. 2 、 4 However, there are risks associated with milnacipran. 2 、 16 、 19 It's crucial to consult with a doctor before considering milnacipran. They can evaluate your condition, any other medications you're taking, and other factors to determine if milnacipran is appropriate for you.

Limitations of Current Research

Research on milnacipran is still limited. 2 、 15 、 9 、 8 、 7 、 19 More research is needed to fully understand the effects and safety of milnacipran. Furthermore, these studies have been conducted on specific types of pain conditions, and it's unclear whether milnacipran is effective for other types of pain.

Future Research Directions

Future research should explore which types of pain milnacipran is most effective for, how to minimize side effects, and how milnacipran interacts with other medications. 2 、 15 、 9 、 8 、 7 、 16 、 19 These studies are expected to lead to safer and more effective uses of milnacipran in pain management.

Conclusion

Milnacipran holds promise as a medication for the treatment of chronic pain conditions such as fibromyalgia and neuropathic pain. 2 、 15 、 9 、 8 、 7 However, there are risks associated with milnacipran, so it's crucial to consult with a doctor before considering its use. 2 、 16 、 19 More research is expected to provide a more complete understanding of the effects and safety of milnacipran.

Literature analysis of 19 papers
Positive Content
19
Neutral Content
0
Negative Content
0
Article Type
4
1
0
0
19
1.

Milnacipran, a new serotonin and noradrenaline reuptake inhibitor: an overview of its antidepressant activity and clinical tolerability.

Author: PuechA, MontgomeryS A, ProstJ F, SollesA, BrileyM

Antidepressant efficacy
Tolerability
Anxiety
Dysuria
Nausea

Milnacipran, a serotonin-norepinephrine reuptake inhibitor, demonstrated similar efficacy to imipramine and superior efficacy to SSRIs in treating depression. It was well tolerated with fewer side effects compared to TCAs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

3.

Electroacupuncture Enhances the Antiallodynic and Antihyperalgesic Effects of Milnacipran in Neuropathic Rats.

Author: LiChengjin, JiByeong Uk, KimYiquot, LeeJi Eun, KimNam-Kwen, KimSeung Tae, KooSungtae

Additive effect with milnacipran
Analgesic effect

This study examined the analgesic effects of electroacupuncture (EA) and its combination with milnacipran in rats with neuropathic pain. EA alone showed analgesic effects, and combined with a subeffective dosage of milnacipran, produced an additive analgesic effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Effects of milnacipran on clinical pain and hyperalgesia of patients with fibromyalgia: results of a 6-week randomized controlled trial.

Author: StaudRoland, LucasYesenia E, PriceDonald D, RobinsonMichael E

Fibromyalgia treatment

This study investigated the effects of milnacipran, a medication used to treat fibromyalgia, on mechanical and heat pain sensitivity in patients with fibromyalgia. The study found that although milnacipran did not show superior efficacy over placebo in reducing clinical pain, changes in mechanical and heat pain sensitivity reliably predicted clinical pain scores.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

The role of spinal serotonin receptor and alpha adrenoceptor on the antiallodynic effects induced by intrathecal milnacipran in chronic constriction injury rats.

Author: NakamuraTakehiro, IkedaTetsuya, TakedaRyuichiro, IgawaKaori, Naono-NakayamaRumi, SakodaSumio, NishimoriToshikazu, IshidaYasushi

Pain relief

This study examines the role of NA and 5-HT receptors in the antiallodynic effect of milnacipran in neuropathic rats. Results indicate that the effect of milnacipran is mediated through α2 adrenoceptors, 5-HT2 and 5-HT3 receptors, and possibly 5-HT1A/1B receptors for mechanical allodynia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

The evaluation of analgesic effects of milnacipran and sertraline in tail-flick test.

Author: KesimM, YanikM N, KadiogluM, PepeogluD, ErkoseogluI, KalyoncuN I, YarisE

Pain relief

This study investigated the analgesic effects of sertraline and milnacipran, antidepressant drugs, in mice using the tail-flick test. Both drugs showed analgesic effects after acute and chronic applications.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effects of milnacipran on cognitive flexibility following chronic stress in rats.

Author: NaegeliKale J, O'ConnorJoann A, BanerjeePradeep, MorilakDavid A

Cognitive flexibility improvement

Chronic unpredictable stress (CUS) in rats impaired cognitive flexibility, but chronic treatment with the serotonin-norepinephrine reuptake inhibitor milnacipran or the selective norepinephrine reuptake blocker desipramine preserved cognitive flexibility. This suggests that milnacipran may be effective in managing cognitive dysfunction associated with stress-related illnesses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Effects of milnacipran, a 5-HT and noradrenaline reuptake inhibitor, on C-fibre-evoked field potentials in spinal long-term potentiation and neuropathic pain.

Author: OhnamiS, KatoA, OgawaK, ShinoharaS, OnoH, TanabeM

Pain relief

The study investigated the effects of milnacipran, an SNRI, on nociceptive synaptic transmission in the spinal cord.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Short-term (2-week) effects of discontinuing milnacipran in patients with fibromyalgia.

Author: SaxePhilippe A, ArnoldLesley M, PalmerRobert H, GendreauR Michael, ChenWei

Improved composite response
Improved functioning
Improved global status
Improved pain

This randomized, placebo-controlled withdrawal study evaluated the effects of discontinuing milnacipran in patients with fibromyalgia. Patients who switched from milnacipran to placebo experienced a significant worsening of pain, functioning, and global status within two weeks compared to those who continued treatment. Notably, discontinuation was not associated with any new safety concerns.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Effects of milnacipran, duloxetine and indomethacin, in polyarthritic rats using the Randall-Selitto model.

Author: MicoJuan Antonio, BerrocosoEsther, VittonOlivier, LadurePhilippe, Newman-TancrediAdrian, BardinLaurent, DepoortèreRonan

Arthritic pain treatment

Milnacipran, a serotonin and noradrenalin reuptake inhibitor, was effective in reducing pain in a rat model of arthritis.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Effects of milnacipran on cardiac repolarization in healthy participants.

Author: PericlouAntonia, PalmerRobert H, ZhengHongjie, LindamoodCharles

No QT prolongation

Milnacipran is approved for treating fibromyalgia. This study examined the effects of supratherapeutic doses of milnacipran on cardiac repolarization in healthy volunteers. The study found no QT prolongation at clinically relevant therapeutic and supratherapeutic concentrations.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Opposite effects of milnacipran, a serotonin norepinephrine reuptake inhibitor, on the levels of nitric oxide and brain-derived neurotrophic factor in mouse brain cortex.

Author: Ikenouchi-SugitaAtsuko, ToyohiraYumiko, YoshimuraReiji, UenoSusumu, TsutsuiMasato, NakamuraJun, YanagiharaNobuyuki

Depression treatment

Milnacipran is a serotonin norepinephrine reuptake inhibitor that has been shown to decrease nitric oxide (NO) levels and increase brain-derived neurotrophic factor (BDNF) levels in the cerebral cortex of mice.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Effects of antidepressants on plasma metabolites of nitric oxide in major depressive disorder: comparison between milnacipran and paroxetine.

Author: Ikenouchi-SugitaAtsuko, YoshimuraReiji, HoriHikaru, Umene-NakanoWakako, UedaNobuhisa, NakamuraJun

Depression treatment

This study examined plasma NOx levels in patients with major depressive disorder and healthy controls. Depressed patients had significantly lower baseline NOx levels than controls. Treatment with milnacipran, but not paroxetine, significantly increased NOx levels after 4 and 8 weeks.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Lower side effects of milnacipran than paroxetine in the treatment of major depression disorder among Han Chinese in Taiwan.

Author: ChangTing-Ting, LêngChhian-Hui, WuJo Yung-Wei, LeeSheng-Yu, WangYu-Shan, ChenYi-Chyan, LuRu-Band

Depression treatment
Side effects

Milnacipran, a dual-action antidepressant, showed similar efficacy to paroxetine in treating major depressive disorder. Milnacipran was associated with fewer side effects such as headache, tremor, and psychomotor retardation compared to paroxetine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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