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.