Key result
Milnacipran use linked to markedly lower H/M ratios and increased wash-out rates on I-MIBG scintigraphy.
Why the study?
The influence of milnacipran on indexes of I-metaiodobenzylguanidine scintigraphy used for Lewy body diseases diagnosis was unclear.
Does milnacipran influence the indexes of I-MIBG scintigraphy in elderly depressed patients?
Observational (n=6)
Does milnacipran influence the indexes of I-MIBG scintigraphy in elderly depressed patients?
Standardized Mean Difference: 1.62
p-value: p=<0.01
Milnacipran significantly alters I-MIBG scintigraphy indexes, potentially causing false-positive results in the diagnosis of Lewy body diseases.
Milnacipran may confound MIBG indexes in elderly depression; leaves open false-positive Lewy body disease risk.
AIM: This study investigated whether or not and how much milnacipran influences the indexes of I-metaiodobenzylguanidine (I-MIBG) scintigraphy, early heart-to-mediastinum (H/M) ratio, delayed H/M ratio, and wash-out rate. METHODS: Six elderly depressed patients participated in the study. All six patients met the diagnostic criteria for a major depressive disorder. They were taking milnacipran for their depression. They needed differential diagnosis for Lewy body diseases due to their symptomatology. I-MIBG scintigraphy was performed twice for each subject, once under prescription of milnacipran and the other without prescription of milnacipran. RESULTS: Both early and delayed phase H/M ratio were significantly lower when taking milnacipran (early phase H/M ratio, P < 0.01, Cohen's d 1.62; delayed phase H/M ratio, P < 0.005, Cohen's d 1.98) than when not taking the drug. Wash-out rate (%) was significantly higher when taking milnacipran (P < 0.05, Cohen's d 2.31) than when off the drug. CONCLUSION: Taking milnacipran substantially influences the indexes of I-MIBG scintigraphy, indicating that taking the drug possibly causes a false-positive result for Lewy body diseases diagnosis.
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Yokoyama et al. (2013) conducted an observational in Major depressive disorder (n=6). Milnacipran vs. Without milnacipran was evaluated on Early heart-to-mediastinum (H/M) ratio (Cohen's d 1.62, p=<0.01). Taking milnacipran significantly lowered early and delayed H/M ratios (P<0.01, Cohen's d 1.62; P<0.005, Cohen's d 1.98) and increased wash-out rate (P<0.05) on I-MIBG scintigraphy.
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