Milnacipran for Attention-Deficit Hyperactivity Disorder Symptoms in Adult Asperger’s Disorder


The efficacy of milnacipran for the treatment of ADHD symptoms in adult Asperger’s disorder patients was examined. Fifteen consecutive adult Asperger’s disorder patients with ADHD symptoms were treated with milnacipran for 8 weeks. Global Assessment of Functioning (GAF) and Conners’ Adult ADHD Rating Scales Objective Screening Version (CAARS-O-SV) were used for the assessment. The mean GAF scores in the 15 patients improved significantly. Inattention, inattention + hyperactivity/impulsivity and ADHD index in CAARS-O-SV were also significantly improved. Milnacipran might be useful for ADHD symptoms, exerting its effects by increasing serotonin and noradrenaline activities in Asperger’s disorder.

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Mashiko, H. , Ishikawa, H. , Itagaki, S. , Takanashi, Y. , Miyashita, N. , Okano, T. , Niwa, S. and Yabe, H. (2014) Milnacipran for Attention-Deficit Hyperactivity Disorder Symptoms in Adult Asperger’s Disorder. Open Journal of Psychiatry, 4, 195-201. doi: 10.4236/ojpsych.2014.43026.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders. 4th Edition, Text Revision. American Psychiatric Press, Washington DC.
[2] Birmaher, B., Quintana, H. and Greenhill, L. (1987) Methylphenidate Treatment of Hyperactive Autistic Children. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 248-251.
[3] Handen, B.L., Johnson, C.R. and Lubetsky, M. (2000) Efficacy of Methylphenidate among Children with Autism and Symptoms of Attention-Deficit Hyperactivity Disorder. Journal of Autism and Developmental Disorders, 30, 245-255.
[4] Quintana, H., Birmaher, B., Stedge, D., Lennon, S., Freed, J., Bridge, J. and Greenhill, L. (1995) Use of Methylphenidate in the Treatment of Children with Autistic Disorder. Journal of Autism and Developmental Disorders, 25, 283-294.
[5] Research Units on Pediatric Psychopharmacology (RUPP) Autism Network (2005) Randomized, Controlled, Crossover Trial of Metylphenidate in Pervasive Developmental Disorders with Hyperactivity. Archives of General Psychiatry, 62, 1266-1274.
[6] Tavakoli, S.A. and Gleason, O.C. (2003) Seizures Associated with Venlafaxine, Methylphenidate, and Zolpidem. Psychosomatics, 44, 262-264.
[7] Martin, A., Koenig, K., Anderson, G.M. and Scahill, L. (2003) Low-Dose Fluvoxamine Treatment of Children and Adolescents with Pervasive Developmental Disorders: A Prospective, Open-Label Study. Journal of Autism and Developmental Disorders, 33, 77-85.
[8] Adler, L.A., Resnick, S., Kunz, M. and Devinsky, O. (1995) Open-Label Trial of Venlafaxinein Adults with Attention Deficit Disorder. Psychopharmacology Bulletin, 31, 785-788.
[9] Carminati, G.G., Deriaz, N. and Bertschy, G. (2006) Low-Dose Venlafaxine in Three Adolescents and Young Adults with Autistic Disorder Improves Self-Injurious Behavior and Attention Deficit/Hyperactivity Disorders (ADHD)-Like Symptoms. Progress in Neuro-Psychopharmacologyand Biological Psychiatry, 30, 312-315.
[10] Chong, Y., Harris, R. and Kim, W.J. (1999) Dystonia as a Side Effect of Nonneuroleptics. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 793-795.
[11] Findling, R.L. and Dogin, J.W. (1998) Psychopharmacology of ADHD: Children and Adolescents. Journal of Clinical Psychiatry, 59, 42-49.
[12] Findling, R.L., Schwartz, M.A., Flannery, D.J. and Manos, M.J. (1996) Venlafaxine in Adults with Attention-Deficit/ Hyperactivity Disorder: An Open Clinical Trial. Journal of Clinical Psychiatry, 57, 184-189
[13] Hedges, D., Reimherr, F.W., Rogers, A., Strong, R. and Wender, P.H. (1995) An Open Trial of Venlafaxine in Adult Patients with Attention Deficit Hyperactivity Disorder. Psychopharmacology Bulletin, 31, 779-783.
[14] Hornig, M. (1998) Addressing Comorbidity in Adults with Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Psychiatry, 59, 69-75.
[15] Hornig-Rohan, M. and Amsterdam, J.D. (2002) Venlafaxine versus Stimulant Therapy in Patients with Dual Diagnosis ADD and Depression. Progressin Neuro-Psychopharmacology and Biological Psychiatry, 26, 585-589.
[16] Kako, Y., Niwa, Y., Toyomaki, A., Yamanaka, H., Kitagawa, N., Denda, K. and Koyama, T. (2007) A Case of Adult Attention-Deficit/Hyperactivity Disorder Alleviated by Milnacipran. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 31, 772-775.
[17] Krause, K.H., Krause, J. and Trott, G.E. (1998) [Hyperkinetic Syndrome (Attention Deficit-/Hyperactivity Disorder) in Adulthood]. Der Nervenarzt, 69, 543-556. (in German)
[18] Maidment, I.D. (2003) The Use of Antidepressants to Treat Attention Deficit Hyperactivity Disorder in Adults. Journal of Psychopharmacology, 17, 332-336.
[19] Mukaddes, N.M. and Abali, O. (2004) Venlafaxine in Children and Adolescents with Attention Deficit Hyperactivity Disorder. Psychiatry and Clinical Neuroscience, 58, 92-95.
[20] Ninan, P.T. (2000) Use of Venlafaxine in Other Psychiatric Disorders. Depression and Anxiety, 12, 90-94.
[21] Olvera, R.L., Pliszka, S.R., Luh, J. and Tatum, R. (1996) An Open Trial of Venlafaxine in the Treatment of AttentionDeficit/Hyperactivity Disorder in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology, 6, 241-250.
[22] Pary, R., Lewis, S., Matuschka, P.R., Rudzinskiy, P., Safi, M. and Lippmann, S. (2002) Attention Deficit Disorder in Adults. Annals of Clinical Psychiatry, 14, 105-111.
[23] Pityaratstian, N. (2005) Advances in Alternative Pharmacotherapy of ADHD. Journal of the Medical Association of Thailand, 88, S357-S362.
[24] Pleak, R.R. and Gormly, L.J. (1995) Effects of Venlafaxine Treatment for ADHD in a Child. American Journal of Psychiatry, 152, 1099.
[25] Popper, C.W. (1997) Antidepressants in the Treatment of Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Psychiatry, 58, 14-29.
[26] Popper, C.W. (2000) Pharmacologic Alternatives to Psychostimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder. Child and Adolescent Psychiatric Clinics of North America, 9, 605-646.
[27] Smith, M.N. (1997) Pharmacologic Properties of Venlafaxine. Journal of Clinical Psychiatry, 58, 178-179.
[28] Upadhyaya, H.P., Brady, K.T., Sethuraman, G., Sonne, S.C. and Malcom, R. (2001) Venlafaxine Treatment of Patients with Comorbid Alcohol/Cocaine Abuse and Attention-Deficit/Hyperactivity Disorder: A Pilot Study. Journal of Clinical Psychopharmacology, 21, 116-118.
[29] Wilens, T.E., Biederman, J. and Spencer, T.J. (1995) Venlafaxine for Adult ADHD. American Journal of Psychiatry, 152, 1099-1100.
[30] Zepf, F.D., Holtmann, M., Stadler, C., Demisch, L., Schmitt, M., Wockel, L. and Poustka, F. (2008) Diminished Serotonergic Functioning in Hostile Children with ADHD: Tryptophan Depletion Increases Behavioral Inhibition. Pharmacopsychiatry, 41, 60-65.
[31] Gadow, K.D., DeVincent, C.J. and Pomeroy, J. (2006) ADHD Symptom Subtypes in Children with Pervasive Developmental Disorder. Journal of Autism and Development Disorders, 36, 271-283.
[32] Conners, C.K., Erhardt, D. and Sparrow, E.P. (1999) Technical Manual. Multi-Health Systems, Inc., North Tonawanda.
[33] Minzenberg, M.J. (2012) Pharmacotherapy for Attention-Deficit/Hyperactivity Disorder: From Cells to Circuits. Neurotherapeutics, 9, 610-621.
[34] Kolevzon, A., Mathewson, K.A. and Hollander, E. (2006) Selective Serotonin Reuptake Inhibitors in Autism: A Review of Efficacy and Tolerability. Journal of Clinical Psychiatry, 67, 407-414.
[35] Puech, A., Montgomery, S.A., Prost, J.F., Solles, A. and Briley, M. (1997) Milnacipran, a New Serotonin and Noradrenaline Reuptake Inhibitor: An Overview of Its Antidepressant Activity and Clinical Tolerability. International Clinical Psychopharmacology, 12, 99-108.

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