Acute electrophysiological effects of intravenous milnacipran, a new antidepressant agent

Abstract Milnacipran is a new antidepressant agent selected from a series of cycloproprane derivatives. The aim of this study was to investigate the acute electrophysiological effects and the tolerance of intravenous administration of this drug in 10 patients without any abnormality as shown in an electrophysiological study done for various complaints. Milnacipran was given over a 30-min period at doses of 0.2 mg/kg (2 patients), 0.4 mg/kg (2 patients) and 0.8 mg/kg (6 patients). The most significant alternations observed in this study were increases in heart rate (average of maximal increase: + 19.5% at 50 min, P = 0.06) and systolic blood pressure (average of maximal increase: + 21.5% at 10 min, P P P P Five of the 10 patients reported transient nausea, four of them for the highest dosage (0.8 mg/kg) and at the moment of peak of milnacipran plasma level. In conclusion, electrophysiological effects of intravenous milnacipran are negligible. These findings differ from those, well described in the literature, for imipramine-like antideprassant agents. Caution should nevertheless be observed when prescribing to patients with marked underlying heart disease or conduction disorders.