Milnacipran: A Serotonin and Norepinephrine Reuptake Inhibitor for the Management of Fibromyalgia Syndrome

July 1, 2009
By Deborah A. Cios, PharmD, Julie E. Kim, PharmD, MBA, BCPS
Modern Medicine

Fibromyalgia syndrome (FMS) is a condition classified by widespread chronic pain and is associated with fatigue, morning stiffness, and disordered sleep. Milnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI) that was recently approved by FDA for the management of FMS. In clinical trials, milnacipran has demonstrated efficacy in reducing FMS symptoms, with patients exhibiting response rates of 25% to 33%. Milnacipran is generally well tolerated and has minimal interactions with concomitant drug therapies. Nausea was the adverse event most frequently reported in clinical trials. In patients with FMS who are unable to tolerate first-line tricyclic antidepressant therapy, milnacipran may be a reasonable alternative or adjunct therapy. More…