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Piloerection induced by replacing fluvoxamine with milnacipran
Satoko Hori1, Nobuko Matsuo, Akiko Yamamoto
1Laboratory of Drug Informatics, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
British Journal of Clinical Pharmacology
|February 28, 2007
Summary
Milnacipran hydrochloride, but not fluvoxamine maleate, increased norepinephrine
Area of Science:
- Pharmacology
- Neuroscience
Background:
- Selective serotonin reuptake inhibitors (SSRIs) like fluvoxamine maleate are commonly prescribed for panic disorder.
- Antidepressants can have varied effects on neurotransmitter systems, including adrenergic receptors.
Observation:
- A patient experiencing piloerection (hair standing on end) after switching from fluvoxamine maleate to milnacipran hydrochloride.
- The piloerection resolved spontaneously and did not recur upon dose increase of milnacipran hydrochloride.
Findings:
- Milnacipran hydrochloride significantly increased alpha(1)-adrenoceptor occupancy by endogenous norepinephrine.
- Fluvoxamine maleate demonstrated minimal effect on alpha(1)-adrenoceptor occupancy.
Implications:
- Milnacipran hydrochloride's effect on alpha(1)-adrenoceptor occupancy may explain the observed piloerection.
- Understanding drug-receptor interactions is crucial for managing antidepressant side effects.
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