Lecrubier Y, Pletan Y, Solles A, Tournoux A, Magne V
INSERM U302, Hôpital Pitié-Salpetrière, Paris, France.
Int Clin Psychopharmacol. 1996 Sep;11 Suppl 4:29-33. doi: 10.1097/00004850-199609004-00004.
The clinical efficacy of milnacipran, a selective serotonin and noradrenaline reuptake inhibitor, was reviewed on the basis of three, multicentre, placebo-controlled trials in major depression. A dose-range study showed the superiority of milnacipran at 50 or 100 mg twice a day compared with placebo whereas the effect of 25 mg twice a day was not clearly distinguished from that of placebo. This has been confirmed by other studies where the 50-mg twice-a-day regimen was shown to be significantly more efficacious than placebo on all outcome measures (Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale, Clinical Global Impression). The positive results in the individual studies were supported by a meta-analysis of the data from the three studies. A subgroup analysis of hospitalized patients in the meta-analysis showed an advantage for milnacipran, suggesting that milnacipran is effective in more severe depression.
基于三项针对重度抑郁症的多中心、安慰剂对照试验，对选择性5-羟色胺和去甲肾上腺素再摄取抑制剂米那普明的临床疗效进行了综述。一项剂量范围研究表明，与安慰剂相比，米那普明每日两次、每次50毫克或100毫克的疗效更优，而每日两次、每次25毫克的效果与安慰剂没有明显差异。其他研究也证实了这一点，即每日两次、每次50毫克的治疗方案在所有疗效指标（汉密尔顿抑郁量表、蒙哥马利-阿斯伯格抑郁量表、临床总体印象）上均显著优于安慰剂。三项研究数据的荟萃分析支持了各项研究中的阳性结果。荟萃分析中对住院患者的亚组分析显示米那普明具有优势，表明米那普明对更严重的抑郁症有效。
