Seizaburo Arita

The clinical use of milnacipran for depression

We examined the relation between dosage and efficacy, and the predictors of response to milnacipran. There was no difference between 50 and 100 mg dose. However, the 100 mg dose had a faster onset of action than the 50 mg dose. An age and an episode have been predictors of milnacipran.

Suitable dose and duration of fluvoxamine administration to treat depression

Abstract The purpose of the present paper was to determine the suitable dose and appropriate trial duration of fluvoxamine to treat for depression. A retrospective cohort analysis was performed among depression patients who were treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000. A total of 72 patients received fluvoxamine to treat depression. The dose–response was compared and the initial significant clinical action was examined. The percentage showing improvement after receiving a high daily dose (100–150u2003mg) of fluvoxamine was 73.7%, but that showing improvement on a low daily dose (50–75u2003mg) was 47.1%. A significant difference between the two groups was seen on Kaplan–Meier analysis and log–rank test (χ2u2003=u20034.814; d.f.u2003=u20031; Pu2003=u20030.0282). The cumulative percentage of responder patients was more than 80% at the end of a 6‐week period. Fluvoxamine is recommended at a daily dose of 100u2003mg or 150u2003mg as the initial dose. If a patient does not show improvement by the end of 6u2003weeks the treatment regimen of fluvoxamine should be altered.

Characteristics and response to milnacipran in painful depression

The quality of the pain experienced in depression and the improvement of pain with depression after treatment with milnacipran was studied. Thirty-three patients with pain combined with depression were studied to analyse the quality of the pain. The quality of the pain was classified into two kinds of pain (surface region pain and deep region pain) using fuzzy theory. A group of 25 patients treated with milnacipran was studied to test the improvement of pain in depression. An analysis of the quality of the pain in depression showed that it was primarily deep region pain, and that this kind of pain was improved with milnacipran treatment. Of 25 patients treated with milnacipran, 21 (84%) responded with a greater than 80% reduction in their pain syndrome. The mechanisms responsible for deep region pain and depression may be associated. Milnacipran appears to be a valuable treatment for patients with pain and depression.

Possible predictors of response to fluvoxamine for depression

INTRODUCTIONnAn investigation of the characteristics of patients being treated with antidepressants would seem to be useful in determining which patients would be most likely benefit from antidepressant medication.nnnAIMSnThe purpose of this preliminary study was to examine the possible predictors of response to fluvoxamine for depression.nnnMETHODnA retrospective cohort analysis was carried out among depression patients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000. Seventy two patients were identified who were receiving fluvoxamine to treat depression.nnnRESULTSnA variety of clinical factors including age, gender, type of depression, frequency of episodes, family history and daily dose of fluvoxamine were examined as possible predictors of the response to fluvoxamine. A Weibull regression analysis showed age, frequency of episodes and daily dose to be the independent predictive factors of improvement in fluvoxamine treatment. The most influential factor was age (ecoef = 2.109), followed by daily dose (ecoef = 0.648) and frequency of episode (ecoef = 0.512). An age of 49 years or younger (chi(2) = 6.767, df = 1, p = 0.0093), a first episode (chi(2) = 9.079, df = 1, p = 0.0026) and a daily dose of 100-150 mg (chi(2) = 5.353, df = 1, p = 0.02) were significantly better predictors of improvement.nnnCONCLUSIONSnAge, the frequency of episodes and the daily dose of fluvoxamine may be considered as predictors of the response to fluvoxamine treatment for depression. This result should be examined in future prospective study.