Abstract
We studied the effect of milnacipran hydrochloride, a newly developed serotonin-noradrenaline-reuptake-inhibitor antidepressant with minimal side effects, in 12 patients with postherpetic neuralgia. All patients had a pain score of at least 40 on a visual-analogue scale (VAS) ranging from 0 (no pain) to 100 (worst pain possible), 3 months after the resolution of herpes zoster. Their pain did not respond to nerve blocks and could not be adequately controlled by currently used drugs. Milnacipran was given at an initial dose of 15 mg/day. The dose was then adjusted according to symptoms. The mean VAS score after 8 weeks of treatment with milnacipran (28.0 ± 17.5) significantly decreased, as compared with the baseline value (68.0 ± 16.9, p < 0.05). The mean daily dose of milnacipran was 52.0 ± 35.1 mg. No relevant side effects were observed. We conclude that milnacipran is useful in patients with postherpetic neuralgia refractory to conventional treatment.
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