Kimura Hiroyuki, Yoshida Keizo, Ito Mikiko, Tokura Tatsuya, Nagashima Wataru, Kurita Kenichi, Ozaki Norio
Department of Psychiatry, Nagoya University Graduate School of Medicine, Japan.
Hum Psychopharmacol. 2012 May;27(3):322-8. doi: 10.1002/hup.2230.
This study was performed to assess the relationship between plasma levels of milnacipran and its analgesic/antidepressive effect in patients with chronic orofacial pain treated with this drug.
A total of 44 patients took milnacipran for 12 weeks. Patients were assessed for their pain and depressive symptoms using the visual analog scale (VAS) and Hamilton Depression Rating Scale, respectively. The plasma milnacipran level was also assessed at week 12.
Forty patients completed study treatment and were included in the analysis. In these patients, the VAS score at week 12 significantly decreased from the baseline score (t = 5.15, p < 0.0001). The dose of milnacipran was positively correlated in a linear manner with the plasma level of the drug (Y = 44.86 + 0.33X, r = 0.54, R(2) = 0.29, p = 0.0004). A quadratic regression curve was plotted between the percentage of decrease in the VAS score and plasma milnacipran level (Y = 27.39 + 0.76X - 0.008X(2) , p = 0.048, r = 0.40, R(2) = 0.16). On the other hand, no significant relationship was noted between the percentage of decrease in the Hamilton Depression Rating Scale score and plasma milnacipran level.
The analgesic effect of milnacipran was suppressed in the presence of the plasma level of the drug outside the therapeutic range, whereas its antidepressant effect was not affected by its plasma level.
本研究旨在评估米那普明血浆水平与使用该药物治疗的慢性口面部疼痛患者的镇痛/抗抑郁效果之间的关系。
共有44例患者服用米那普明12周。分别使用视觉模拟量表（VAS）和汉密尔顿抑郁量表对患者的疼痛和抑郁症状进行评估。在第12周时也评估了血浆米那普明水平。
40例患者完成了研究治疗并纳入分析。在这些患者中，第12周时的VAS评分较基线评分显著降低（t = 5.15，p < 0.0001）。米那普明的剂量与该药物的血浆水平呈线性正相关（Y = 44.86 + 0.33X，r = 0.54，R(2) = 0.29，p = 0.0004）。绘制了VAS评分降低百分比与血浆米那普明水平之间的二次回归曲线（Y = 27.39 + 0.76X - 0.008X(2)，p = 0.048，r = 0.40，R(2) = 0.16）。另一方面，汉密尔顿抑郁量表评分降低百分比与血浆米那普明水平之间未发现显著关系。
当药物血浆水平超出治疗范围时，米那普明的镇痛作用受到抑制，而其抗抑郁作用不受血浆水平影响。
