Puech A, Montgomery S A, Prost J F, Solles A, Briley M
Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Int Clin Psychopharmacol. 1997 Mar;12(2):99-108. doi: 10.1097/00004850-199703000-00005.
Milnacipran (Ixel) is a new antidepressant with essentially equal potency for inhibiting the reuptake of both serotonin and noradrenaline, with no affinity for any neurotransmitter receptor studied. A review of the studies comparing milnacipran, placebo and active comparator antidepressants provides clear-cut evidence of its efficacy in both severe and moderate depression in hospitalized and community settings. Meta-analyses of the original data of controlled trials involving 1032 patients, comparing milnacipran with imipramine or selective serotonin reuptake inhibitors (SSRIs), show that milnacipran provides antidepressant efficacy similar to that of imipramine and significantly superior to that of the SSRIs. An analysis of a database of over 3300 patients shows that both the general and cardiovascular tolerability of milnacipran are superior to those of the tricyclic antidepressants (TCAs) with fewer cholinergic side-effects. The tolerability of milnacipran was comparable to that of the SSRIs, with a higher incidence of dysuria with milnacipran, and a higher frequency of nausea and anxiety with the SSRIs. Milnacipran is a new therapeutic option in depression, which offers a clinical efficacy in the range of the TCAs combined with a tolerability equivalent to that of the SSRIs.
米那普明（喜普妙）是一种新型抗抑郁药，对5-羟色胺和去甲肾上腺素再摄取的抑制作用基本相同，对所研究的任何神经递质受体均无亲和力。对比较米那普明、安慰剂和活性对照抗抑郁药的研究进行综述，可清楚证明其在住院患者和社区患者的重度及中度抑郁症治疗中均有效。对涉及1032例患者的对照试验原始数据进行的荟萃分析，比较了米那普明与丙咪嗪或选择性5-羟色胺再摄取抑制剂（SSRI），结果显示米那普明的抗抑郁疗效与丙咪嗪相似，且显著优于SSRI。对一个超过3300例患者的数据库进行分析表明，米那普明的总体耐受性和心血管耐受性均优于三环类抗抑郁药（TCA），胆碱能副作用较少。米那普明的耐受性与SSRI相当，米那普明导致排尿困难的发生率较高，而SSRI导致恶心和焦虑的频率较高。米那普明是抑郁症治疗的一种新选择，它具有与TCA相当的临床疗效，并具有与SSRI相当的耐受性。
