Addition of a dopamine agonist, cabergoline, to a serotonin-noradrenalin reuptake inhibitor, milnacipran as a therapeutic option in the treatment of refractory depression: two case reports

Clin Neuropharmacol. 2003 Sep-Oct;26(5):230-2. doi: 10.1097/00002826-200309000-00005.

Abstract

We illustrate 2 patients with depression who attained dramatic improvement of energy loss and fatigue when treated with cabergoline, a dopamine agonist, and milnacipran, a serotonin-noradrenalin reuptake inhibitor. Although the biologic basis of energy, motivation, and fatigue in association with depression remains unknown, some reports suggest that the decrease of noradrenalin and dopamine in the brain are particularly related to these symptoms. Therefore, treatment strategy that enhances these two monoamine neurotransmissions may be appropriate for getting a boost in energy and eliminating fatigue in patients with depression. These cases suggest that further studies are warranted to confirm the potential benefit of this strategy in the treatment of patients with depression who failed to attain complete remission due to residual symptoms including energy loss and fatigue refractory to previous treatments.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic Uptake Inhibitors / therapeutic use
  • Adult
  • Cabergoline
  • Cyclopropanes / therapeutic use*
  • Depressive Disorder, Major / drug therapy*
  • Depressive Disorder, Major / psychology
  • Dopamine Agonists / therapeutic use*
  • Drug Therapy, Combination
  • Ergolines / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Milnacipran
  • Selective Serotonin Reuptake Inhibitors / therapeutic use

Substances

  • Adrenergic Uptake Inhibitors
  • Cyclopropanes
  • Dopamine Agonists
  • Ergolines
  • Serotonin Uptake Inhibitors
  • Milnacipran
  • Cabergoline