JohnBoy2000
Bluelighter
- Joined
- May 11, 2016
- Messages
- 2,465
Milnacipran - any reason why this was not approved for MDD??
Pharmaco-bureaucracy?
From Wikipedia:
"In a pooled analysis of 7 comparative trials with imipramine,[1] milnacipran and imipramine were shown to have comparable efficacy while milnacipran was significantly better tolerated. A pooled analysis of studies comparing milnacipran and SSRIs[2] concluded a superior efficacy for milnacipran with similar tolerability for milnacipran and SSRIs."
https://www.ncbi.nlm.nih.gov/pubmed/12369608
Seems like a solid SNRI - higher NRI to SRI ratio.
Could it genuinely be competition between newer drugs like Duloxetine?
Or is there any actual reason this drug is not licenced?
From Wikipedia:
"In a pooled analysis of 7 comparative trials with imipramine,[1] milnacipran and imipramine were shown to have comparable efficacy while milnacipran was significantly better tolerated. A pooled analysis of studies comparing milnacipran and SSRIs[2] concluded a superior efficacy for milnacipran with similar tolerability for milnacipran and SSRIs."
https://www.ncbi.nlm.nih.gov/pubmed/12369608
"The pharmacokinetic profile of milnacipran is characterized by rapid absorption, high bioavailability, low protein binding, and rapid elimination, both by hepatic glucuronidation and renal excretion. This gives milnacipran certain pharmacokinetic advantages, such as low inter-individual variation in plasma levels, low potential for drug interactions, and limited impact on hepatic cytochrome P450 systems."
Seems like a solid SNRI - higher NRI to SRI ratio.
Could it genuinely be competition between newer drugs like Duloxetine?
Or is there any actual reason this drug is not licenced?