Parkinsonism associated with a serotonin and noradrenaline reuptake inhibitor, milnacipran

Abstract

Milnacipran is a new class of antidepressant, a dual serotonin (5-HT) and noradrenaline (norepinephrine) reuptake inhibitor (SNRI).1 It shows no affinity for neurotransmitter receptors.1 The use of selective serotonin reuptake inhibitor (SSRI) has been associated with the occurrence and worsening of parkinsonism.2,3 However, SNRI induced parkinsonism has not been reported. A case is reported here in which severe parkinsonism occurred in association with the use of milnacipran. A 83 year old woman was prescribed 200 mg of etidronate disodium once daily, and 0.25 μg of calcitriol for osteoporosis. In July 2001, she was prescribed 15 mg of milnacipran twice daily to alleviate her depressive …