We examined the effects of the administration of milnacipran, a dual inhibitor of serotonin (5-hydroxytryptamine, 5-HT) and noradrenaline uptake on the 5-HT output in rat brain. Local milnacipran administration increased the 5-HT output in frontal cortex and the midbrain raphe nuclei 7-and 10-fold by a Ca 2 ϩ -and tetrodotoxin-dependent mechanism. However, the subcutaneous administration of milnacipran (1-60 mg/kg SC) elevated the 5-HT output much less in these areas (200-230% of baseline at 60 mg/kg). In hypothalamus, 10 mg/kg SC raised 5-HT levels to 170%. The 5-HT 1A antagonist WAY-100635 caused a small potentiation of the effects of milnacipran. The baseline 5-HT output was unaffected by 2-week treatments with milnacipran (30 and 60 mg/kg и day). The distinct regional profile and the lack of enhancement of its effects by WAY-100635 and prolonged treatment suggest that milnacipran does not exert itsThe administration of selective 5-HT reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and clomipramine markedly increases the extracellular concentration of 5-HT in the raphe nuclei of the midbrain (Adell and Artigas 1991; Bel and Artigas 1992;Invernizzi et al. 1992;Celada and Artigas 1993;Gartside et al. 1995;Malagié et al. 1995). In all instances, these elevations are superior to those produced in frontal cortex or, when examined, in hippocampus. The excess 5-HT in the extracellular space of the midbrain raphe activates 5-HT 1A autoreceptors in the soma and dendrites of serotonergic neurones and reduces the neuronal activity and release of 5-HT by nerve terminals in forebrain (see for review).Selective serotonin (5-hydroxytryptamine, 5-HT) and noradrenaline reuptake inhibitors (SNRIs) are a new class of antidepressant drugs. These agents inhibit in vitro the neuronal uptake of 5-HT and noradrenaline without exhibiting significant activity at the dopamine transporter or aminergic receptors (see Artigas 1995; Briley 1998 for review). Consequently, they are devoid of the unwanted side effects of classic antidepressant Received January 17, 1999; revised May 21, 1999; accepted June 18, 1999. 746 N. Bel and F. Artigas N EUROPSYCHOPHARMACOLOGY 1999 -VOL . 21 , NO . 6 drugs, mainly derived from their affinity for ␣ -adrenergic, cholinergic, and histamine receptors (Richelson 1978;Richelson and Nelson 1984). Milnacipran is one such drug that blocks in vitro and in vivo the reuptake of 5-HT and noradrenaline, although it displays a slightly higher affinity for the latter (Moret et al. 1985;Stenger et al. 1987).Despite the potential advantages of SNRIs, the information on their in vivo effects on serotonergic transmission is scarce (e.g., Engleman et al. 1995;. In particular, a comparison of their effects in the somatodendritic region in the raphe nuclei and in forebrain has not been performed. Data obtained with the microdialysis technique suggest that the dual blockade of the 5-HT and noradrenaline transporters elevates the extracellular 5-HT concentration in rat brain, with a regional profile d...