Efficacy and safety of milnacipran in the treatment of generalized anxiety disorder: an open study

OBJECTIVE The aim of this open study was to assess the efficacy and safety of the serotonin–noradrenaline reuptake-inhibiting antidepressant, milnacipran, for the treatment of generalised anxiety disorder.

METHODS Twelve patients, treated with milnacipran at doses from 30 to 150 mg/day for 8 weeks, were evaluated at baseline and after 1, 2, 3, 4, 6 and 8 weeks of treatment using the Hamilton Anxiety Rating (HAM-A) scale and a self-rating visual analogue scale.

RESULTS Two patients dropped out early in the trial because of adverse effects. The 10 patients who completed the trial showed a marked improvement in anxiety symptoms with HAM-A scores being reduced from 21.6±6.5 (mean±SD) to 1.5±1.8 after 8 weeks. All of the patients who completed the 8 weeks of treatment had a reduction of at least 70% in their HAM-A score. Adverse effects, principally nausea, were mild and occurred early in the study, regressing as the study progressed.

CONCLUSION These results suggest that milnacipran is effective and well tolerated in patients suffering from generalised anxiety disorder. A full-scale double-blind placebo trial is clearly warranted.