Why the study?
Does milnacipran improve pain without prolonging QT interval in a patient with congenital long QT syndrome and pain disorder?
Does milnacipran improve pain without prolonging QT interval in a patient with congenital long QT syndrome and pain disorder?
Milnacipran may be a safe and effective alternative for treating pain disorder in patients with congenital long QT syndrome for whom tricyclic antidepressants are contraindicated.
May support milnacipran for pain in congenital long QT syndrome; hypothesis-generating and needs prospective validation.
The effectiveness of tricyclic antidepressants (TCAs) has been reported for treating pain disorder. However, the use of TCAs is contraindicated for patients with congenital long QT syndrome. We experienced a case of a 38-year-old woman with congenital long QT syndrome and pain disorder in the orofacial region, which was treated successfully with milnacipran. Although nortriptyline was effective for her pain, it could bring about fatal cardiac adverse events. Paroxetine was not effective in this case. Six weeks after the increase to 200 mg/d of milnacipran, her pain had completely disappeared, and her corrected QT interval time was 0.445 milliseconds. Milnacipran may be a safe and effective compound for patients with pain disorder in whom TCAs are contraindicated.
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Ikawa et al. (2010) studied this question.
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