Milnacipran influences the indexes of I-metaiodobenzylguanidine scintigraphy in elderly depressed patients

Authors

  • Katsutoshi Yokoyama MD,

    Corresponding author
    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    • Correspondence: Katsutoshi Yokoyama, MD, Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, 36-1 Nishi-cho, Yonago 683-8504, Japan. Email: kyinyonago@yahoo.co.jp

    Search for more papers by this author
  • Takeshi Yamada PhD,

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Sayaka Terachi,

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Shenghong Pu PhD,

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Yasutoshi Ohta MD,

    1. Division of Radiology, Department of Pathophysiological Therapeutic Sciences, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Takehiko Yamanashi MD,

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Hiroshi Matsumura MD,

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author
  • Kazuyuki Nakagome PhD,

    1. National Center of Neurology and Psychiatry, Tokyo, Japan
    Search for more papers by this author
  • Koichi Kaneko PhD

    1. Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University, Faculty of Medicine, Yonago, Japan
    Search for more papers by this author

Abstract

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.

Ancillary