Plasma levels of milnacipran and its effectiveness for the treatment of chronic pain in the orofacial region

Human Psychopharmacology: Clinical and Experimental, 05/17/2012

The analgesic effect of milnacipran was suppressed in the presence of the plasma level of the drug outside the therapeutic range, whereas its antidepressant effect was not affected by its plasma level.


  • A total of 44 patients took milnacipran for 12 weeks.
  • Patients were assessed for their pain and depressive symptoms using the visual analog scale (VAS) and Hamilton Depression Rating Scale, respectively.
  • The plasma milnacipran level was also assessed at week 12.


  • Forty patients completed study treatment and were included in the analysis.
  • In these patients, the VAS score at week 12 significantly decreased from the baseline score (t = 5.15, p < 0.0001).
  • The dose of milnacipran was positively correlated in a linear manner with the plasma level of the drug (Y = 44.86 + 0.33X, r = 0.54, R2 = 0.29, p = 0.0004).
  • A quadratic regression curve was plotted between the percentage of decrease in the VAS score and plasma milnacipran level (Y = 27.39 + 0.76X-0.008X2, p = 0.048, r = 0.40, R2 = 0.16).
  • On the other hand, no significant relationship was noted between the percentage of decrease in the Hamilton Depression Rating Scale score and plasma milnacipran level.

Print Article Summary Cat 2 CME Report