Levomilnacipran, the more active enantiomer of the serotonin and norepinephrine reuptake inhibitor (SNRI) milnacipran, was recently approved in the US for the treatment of major depressive disorder (MDD). The drug was developed as an extended release (ER) capsule formulation to allow for once-daily administration, thereby improving patient adherence. This agent differs from other available SNRIs in having a greater potency for inhibition of norepinephrine relative to serotonin reuptake. The efficacy of levomilnacipran ER has been evaluated in seven randomised, double-blind clinical trials (one Phase II and four Phase III trials, and two long-term efficacy studies). These studies documented that levomilnacipran is generally more effective than placebo for the treatment of MDD in the short-term, whereas no firm evidence exists on long-term efficacy for relapse prevention. Preliminary evidence suggests that levomilnacipran ER may be effective in improving not only depressive symptoms but also symptoms related to functioning (social life, work, and family life). Short-and longer-term studies found that the rate of withdrawal from levomilnacipran therapy due to adverse events was rather low. Moreover the drug appeared to be generally well tolerated. The most common adverse effects included nausea, hyperhidrosis, constipation, tachycardia, palpitations, erectile dysfunction and ejaculation disorder. As hypertension or orthostatic hypotension may occur in a few patients, the cardiovascular safety of levomilnacipran needs to be more extensively investigated especially on long-term treatment. Additional active comparator trials evaluating efficacy, tolerability and cost-effectiveness are required to better define the role of levomilnacipran ER in the treatment of MDD in relation to currently available antidepressants including other SNRIs.
Keywords: Antidepressants, efficacy, levomilnacipran extended release, major depressive disorder, safety, tolerability.
Nonfatal Suicidal Overdose of Olanzapine in an Adolescent
Current Drug Safety Buckwheat: A Useful Food and Its Effects on Human Health
Current Nutrition & Food Science State of the Art Management of Transfusion-Related Acute Lung Injury (TRALI)
Current Pharmaceutical Design 6-Oxo-Morphinane Oximes: Pharmacology, Chemistry and Analytical Application
Current Medicinal Chemistry Progress in Syntheses of 3-n-Butylphthalide and Its Analogues
Current Organic Chemistry ACE Inhibition Prevents Diastolic Ca2+ Overload and Loss of Myofilament Ca2+ Sensitivity after Myocardial Infarction
Current Molecular Medicine Hypertension in Hemodialysis Patients
Current Hypertension Reviews Effects of Peroxyl Radicals on Contractility of Rabbit Aorta and Guinea Pig Atria
Endocrine, Metabolic & Immune Disorders - Drug Targets Lactic Acidosis, Hypotension, and Sensorineural Hearing Loss Following Intentional Metformin Overdose
Current Drug Safety Anti-Inflammatory Approaches to Reduce Acute Cardiovascular Events: Not Only Benefits
Current Pharmaceutical Biotechnology Prevention of Endothelial Cell Injury by Activated Protein C: The Molecular Mechanism(s) and Therapeutic Implications
Current Vascular Pharmacology Isolation and Identification of an Angiotensin-I Converting Enzyme Inhibitory Peptide from Yeast (Saccharomyces cerevisiae)
Current Analytical Chemistry The Guanylyl Cyclase Inhibition by MB as Vasoplegic Circulatory Shock Therapeutical Target
Current Drug Targets Hypotensive Effect of Hydroalcoholic Ziziphus jujuba Extract on Normotensive Rats
Current Nutrition & Food Science Dopamine Administration in Very Low Birth Weight Preterm Infants:Emerging Issues on Endocrine Effects
Current Pediatric Reviews Experimental Model Considerations for the Study of Protein-Energy Malnutrition Co-Existing with Ischemic Brain Injury
Current Neurovascular Research Cardiovascular effect of Nigella sativa L. Aqueous Extract in Normal Rats
Cardiovascular & Hematological Disorders-Drug Targets What is the Evidence for the use of Adrenaline in the Treatment of Neonatal Hypotension?
Cardiovascular & Hematological Agents in Medicinal Chemistry Hypotensive Agents from Snake Venoms
Current Drug Targets - Cardiovascular & Hematological Disorders Nerve Injury Associated with Regional Anesthesia
Current Topics in Medicinal Chemistry