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Both newer and older drugs are generally equally effective in new onset epilepsy. [42] The newer drugs tend to have fewer side effects. [42] For newly diagnosed partial or mixed seizures, there is evidence for using gabapentin, lamotrigine, oxcarbazepine or topiramate as monotherapy. [42]
Tianeptine also has anticonvulsant and analgesic effects, [31] and a clinical trial in Spain that ended in January 2007 has shown that tianeptine is effective in treating pain due to fibromyalgia. [32] Tianeptine has been shown to have efficacy with minimal side effects in the treatment of attention-deficit hyperactivity disorder. [33]
Discontinuation of treatment due to side effects was common. [64] Antidepressants including amitriptyline, fluoxetine, duloxetine, milnacipran, moclobemide, and pirlindole are recommended by the European League Against Rheumatism (EULAR) for the treatment of fibromyalgia based on "limited evidence". [65]
During its development for fibromyalgia, milnacipran was evaluated utilizing a composite responder approach.To be considered as a responder for the composite ‘treatment of fibromyalgia’ endpoint, each patient had to show concurrent and clinically meaningful improvements in pain, physical function, and global impression of disease status.
The use of medication in the treatment of fibromyalgia is debated, [18] [19] although antidepressants can improve quality of life. [20] Other medications commonly considered helpful in managing fibromyalgia include serotonin–norepinephrine reuptake inhibitors , nonsteroidal anti-inflammatory drugs , and muscle relaxants . [ 21 ]
Rates of sexual dysfunction in MDD patients treated with duloxetine versus escitalopram did not differ significantly at 4, 8, and 12 weeks of treatment, although the trend favored duloxetine (33.3% of duloxetine patients experienced sexual side effects compared to 43.6% of those receiving escitalopram and 25% of those receiving placebo).