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got this of of fibro aware site Heidi

Efficacy of milnacipran in patients with fibromyalgia

J Rheumatol. 2005 Oct;32(10):1975-85.

Gendreau RM, Thorn MD, Gendreau JF, Kranzler JD, Ribeiro S, Gracely

RH, DA, Mease PJ, McLean SA, Clauw DJ.

OBJECTIVE: Fibromyalgia (FM) is a common musculoskeletal condition

characterized by widespread pain, tenderness, and a variety of other

somatic symptoms. Current treatments are modestly effective.

Arguably, the best studied and most effective compounds are tricyclic

antidepressants (TCA). Milnacipran, a nontricyclic compound that

inhibits the reuptake of both serotonin and norepinephrine, may

provide many of the beneficial effects of TCAwith a superior side

effect profile.

METHODS: One hundred twenty-five patients with FMwere randomly

assigned in a 3:3:2 ratio to receive milnacipran twice daily,

milnacipran once daily, or placebo for 3 months in a double-blind

dose-escalation trial; 92% of twice-daily and 81% of once-daily

participants achieved dose escalation to the target milnacipran dose

of 200 mg.

RESULTS: The primary endpoint was reduction of pain. Both the once-

and twice-daily groups showed statistically significant improvements

in pain, as well as improvements in global well being, fatigue, and

other domains. Response rates for patients receiving milnacipran were

equal in patients with and without comorbid depression, but placebo

response rates were considerably higher in depressed patients,

leading to significantly greater overall efficacy in the nondepressed

group.

CONCLUSION: In this Phase IIstudy, milnacipran led to statistically

significant improvements in pain and other symptoms of FM. The effect

sizes were equal to those previously found with TCA, and the drug was

generally well tolerated.

POWERPOINT] This is a Sample of a Title Page ... Clomipramine.

Dothiepim. Doxepin. Tetracyclic. Maprotiline. Mirtazapine. SSRIs.

Citalopram. Fluoxetine. Sertaline. Paroxetine. SNRIs. Duloxetine.

Milnacipran. ...

www.fmaware.org/site/DocServer/PsychIssuesFM808.ppt?docID=1661

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