Savella (milnacipran) / AbbVie, Pierre Fabre - LARVOL DELTA

Examining individual serotonin and norepinephrine reuptake inhibitors and fall-related hospitalizations in older adults. (PubMed, Ment Health Clin) - "Data were drawn from Merative MarketScan Medicare Supplemental claims (January 1, 2015 to November 30, 2021), including adults 65 years and older prescribed an SNRI (ie, duloxetine, venlafaxine, desvenlafaxine, milnacipran, levomilnacipran). Venlafaxine appears to have a lower fall risk than duloxetine. Further studies are needed to determine clinical significance and assess fall-related costs to support safer SNRI use in older adults."

Journal • Geriatric Disorders

Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia. (PubMed, JAMA Netw Open) - "Amitriptyline provided greater net benefit than milnacipran and the lower doses of pregabalin and duloxetine. These findings may help inform the selection of value-based treatments for moderate to severe FM."

HEOR • Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Milnacipran for the treatment of refractory chronic cough: a report of two cases (PubMed, Zhonghua Jie He He Hu Xi Za Zhi) - "No recurrence was noted during an eight-week follow-up after drug withdrawal. These cases suggest that, in the absence of psychiatric disorders, milnacipran may effectively relieve cough symptoms in patients with RCC and could represent a promising therapeutic option for this condition."

Journal • Asthma • Chronic Cough • CNS Disorders • Cough • Gastroenterology • Gastroesophageal Reflux Disease • Immunology • Mental Retardation • Psychiatry • Pulmonary Disease • Renal Cell Carcinoma • Respiratory Diseases

Prediction of 12-Week Remission in Patients With Depressive Disorder Using Reasoning-Based Large Language Models: Model Development and Validation Study. (PubMed, JMIR Ment Health) - "We analyzed data from 390 patients in the MAKE Biomarker discovery study who were undergoing first-step antidepressant monotherapy with 12 different medications, including escitalopram, paroxetine, sertraline, duloxetine, venlafaxine, desvenlafaxine, milnacipran, mirtazapine, bupropion, vortioxetine, tianeptine, and trazodone, after excluding those with uncommon medications (n=9) or missing biomarker data (n=32). Clinical evaluation by psychiatrists showed favorable mean ratings for correctness (4.3, SD 0.7), consistency (4.2, SD 0.8), specificity (4.2, SD 0.7), helpfulness (4.2, SD 1.0), and human likeness (3.6, SD 1.7) on 5-point scales. These findings demonstrate that reasoning-based LLMs, particularly when enhanced with research-informed prompting, show promise for predicting antidepressant response and could serve as interpretable adjunctive tools in depressive disorder treatment planning, although prospective validation in real-world clinical settings remains..."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

From Years of Pain to a Name: Fibromyalgia Uncovered. (PubMed, Cureus) - "Effective pharmacologic options include duloxetine, milnacipran, pregabalin, and amitriptyline. However, after ruling out the common causes for diffuse chronic pain, fibromyalgia was diagnosed. This case illuminates the importance of clinicians being patient advocates throughout the journey and listening attentively to patients' concerns even when laboratory results and imaging appear unremarkable."

Journal • Bipolar Disorder • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Depression • Dermatology • Fatigue • Fibromyalgia • Gastrointestinal Disorder • Hidradenitis Suppurativa • Immunology • Major Depressive Disorder • Melanoma • Mood Disorders • Musculoskeletal Pain • Nephrology • Oncology • Pain • Post-traumatic Stress Disorder • Psychiatry • Renal Disease • Rheumatology • Solid Tumor

Sublingual cyclobenzaprine (Tonmya) for fibromyalgia. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Disproportionality analysis of safety signals for milnacipran and levomilnacipran: a pharmacovigilance study using the FDA adverse event reporting system. (PubMed, Front Pharmacol) - "This real-world pharmacovigilance study has highlighted the distinct adverse event profiles of milnacipran and levomilnacipran, with a particular emphasis on sex-specific reactions. This differentiation supports the adoption of precision prescribing strategies and addresses the limitations often encountered in traditional clinical trial data."

Adverse events • Journal • Cardiovascular • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Pain • Psychiatry • Suicidal Ideation

KETAPAL: Evaluation of the Initial Prescription of Ketamine and Milnacipran in Depression in Patients With a Progressive Disease (clinicaltrials.gov) - P2/3 | N=42 | Completed | Sponsor: University Hospital, Lille | Recruiting ➔ Completed | N=80 ➔ 42

Enrollment change • Trial completion • CNS Disorders • Depression • Mood Disorders • Psychiatry

Current pharmacological management, treatment challenges and potential future treatment options for Fibromyalgia syndrome. (PubMed, Expert Opin Pharmacother) - "Current pharmacological options include drugs like Pregabalin, Duloxetine, and Milnacipran, alongside off-label therapies and emerging treatments such as antivirals and cannabinoids. FMS is not a diagnosis of exclusion and diagnosis of FMS can allow a patients distress to be explained and understood. Though no cure exists for FMS management strategies have been shown to improve patients' symptoms and quality of life."

Journal • Review • Fatigue • Fibromyalgia • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Rheumatology

Using Seizure Dynamotypes to Predict Response to Antiseizure Medications (AES 2025) - "Also: Undergraduate Research Opportunities Program at the University of Utah, NIH NINDS: F32 NS114322 awarded to Daria Anderson and University of Utah Skaggs Fellowship awarded to Ashley Zachery-Savella Rationale: Epilepsy treatment is complicated by the fact that patients with similar phenotypes and seizure classifications do not respond similarly to the same treatments, suggesting subtler differences exist that cannot be accounted for by our currently-limited classification system... We analyzed seizure frequency and dynamotype in six treatment cohorts: 294 seizures/21 animals in the carbamazepine (30 mg/kg, t.i.d.) cohort, 820 seizures/17 animals in the phenobarbital (PB, 50 mg/kg, b.i.d.) cohort, 848 seizures/22 animals in the valproate (VPA, 240 mg/kg, t.i.d.) cohort, and 825 seizures/21 animals in the phenytoin (PHT, 20 mg/kg, b.i.d.) cohort... Dynamotype analysis reveals drug-specific modulation of seizure onset and offset patterns. PHT did not reduce seizure..."

CNS Disorders • Epilepsy

A multivariate index to quantify fibromyalgia-like phenotypes in rodents: utility for drug screening and model validation (Neuroscience 2025) - "To assess predictive validity, we tested drugs with known or proposed clinical relevance on SS rats: Pregabalin and Milnacipran (FDA-approved for FMS), Indomethacin (NSAID), DAMGO (opioid agonist), and Metformin (a repurposing candidate). The SS rat exhibited predictive pharmacological patterns reflective of clinical data. The findings position the FAM index as a powerful platform for advancing FMS research and identify Metformin as a promising therapeutic candidate."

Preclinical • Addiction (Opioid and Alcohol) • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Mood Disorders • Musculoskeletal Pain • Pain • Psychiatry

The Differential Involvement of α1-Adrenoceptor Subtypes in the Molecular Effects of Antidepressant Drugs. (PubMed, Int J Mol Sci) - "We investigated whether the functional involvement of α1-adrenergic receptors (α1-AR) in the effects induced by antidepressant drugs, desipramine, and milnacipran varies depending on the α1-AR subtype. The pattern of changes differed by gender. Our study revealed the functional diversity between α1-AR subtypes in the molecular mechanisms of antidepressants' drug action."

Journal • GSK3B

Randomized, Double-Blind, Placebo-Controlled Clinical Study on Milnacipran Hydrochloride Tablets for the Treatment of Somatic Cough Disorder (ChiCTR) - P1 | N=60 | Recruiting | Sponsor: ShangHai Tongji Hospita; ShangHai Tongji Hospita

New P1 trial • Cough • Respiratory Diseases

Pharmacologic treatment of fibromyalgia: an update. (PubMed, Front Pharmacol) - "Pharmacological therapy remains unsatisfactory: only pregabalin, duloxetine, and milnacipran have gained U.S. FDA approval, providing clinically meaningful relief in a minority of patients, and their frequent adverse events limit adherence. Numerous other agents, including cyclobenzaprine, gabapentinoids, NMDA antagonists, cannabinoids, and sodium oxybate, have been evaluated, but most remain investigational or limited by safety concerns. Current guidelines emphasize that pharmacological interventions alone are insufficient and should be integrated with non-pharmacological strategies, especially patient education, exercise, and psychological support. This review summarizes the evidence on available and emerging pharmacological options for FM, highlights their limitations, and underscores the need for individualized, multimodal treatment strategies to improve patient outcomes and quality of life."

Journal • Review • CNS Disorders • Cognitive Disorders • Fatigue • Fibromyalgia • Mood Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology • Sleep Disorder

Physician Practices and Perspectives in the Diagnosis and Management of Fibromyalgia: A US Chart Review Study (ACR Convergence 2025) - "Eligible HCPs had been practicing ≥2 years, treated ≥20 adult patients with FM over the past 3 months, and were aware of duloxetine, milnacipran, or pregabalin...Across all respondents' treated patients, duloxetine, gabapentin, and pregabalin were evenly used across lines of therapy; use of opioids (including tramadol) was more common in the third line and beyond (33% of ≥third line patients)... This recent patient chart review among US-based HCPs who are highly experienced in managing patients with FM shows continuing variability in diagnostic and treatment practices, limited satisfaction with current therapies, and concern that patients are unlikely to improve despite treatment even though progress has been made in disease area knowledge and earlier identification. Greater knowledge of FM, its diagnosis and management, and new treatment options will help further support patient care and improve outcomes."

Review • Fatigue • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Good Evidence That Duloxetine, Milnacipran, and Pregabalin Provide Meaningful Pain Reduction in Adults With Fibromyalgia. (PubMed, Am Fam Physician) - No abstract available

Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

In Search of Molecular Correlates of Fibromyalgia: The Quest for Objective Diagnosis and Effective Treatments. (PubMed, Int J Mol Sci) - "Therapeutic management remains multidisciplinary, combining pharmacological interventions (e.g., duloxetine, pregabalin, milnacipran) with non-pharmacological strategies such as graded aerobic exercise and cognitive behavioral therapy. Future priorities include large-scale validation of biomarkers, integration of multi-omics with clinical phenotyping, and the design of precision-guided trials. By synthesizing mechanistic insights with clinical evidence, this review provides an updated framework for the diagnosis and management of fibromyalgia, highlighting pathways toward biomarker-guided, personalized medicine."

Biomarker • Journal • Review • Alzheimer's Disease • Cognitive Disorders • Fatigue • Fibromyalgia • Inflammation • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Rheumatology

Side effect profile and comparative tolerability of newer generation antidepressants in the acute treatment of major depressive disorder in children and adolescents: protocol for a systematic review and network meta-analysis. (PubMed, BMJ Open) - "The following antidepressants will be considered: agomelatine, alaproclate, bupropion, citalopram, desvenlafaxine, duloxetine, edivoxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, venlafaxine, vilazodone and vortioxetine. The findings will be published in a peer-reviewed journal and may be presented at international conferences. CRD420251011399."

Adverse events • Journal • Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • Suicidal Ideation

Response probability to single intravenous racemic ketamine with psychopharmacological combinations: a pooled post-hoc study (ECNP 2025) - "The combination of ketamine with antidepressants that block 5-HT2A receptors (such as mirtazapine, mianserine, trazodone, and agomelatine; n = 41) significantly increased the response rate to 58.5%, compared to 28.9% in those who did not receive these combinations. In contrast, combining ketamine with serotonin reuptake inhibitors (escitalopram, fluoxetine, paroxetine, sertraline, vortioxetine; n = 34) or with antipsychotics characterized by higher D2 than 5-HT2A blockade (amisulpride, aripiprazole, cariprazine; n = 10) significantly reduced the response rate to 26.5% and 0%, respectively, compared to 53.8% and 48.7% in those not receiving these combinations. Combination of ketamine with serotonin and norepinephrine reuptake inhibitors (clomipramine, venlafaxine, duloxetine, milnacipran; n = 30) or with antipsychotics (n = 40), compared to ketamine without SNRIs or without antipsychotics, did not significantly alter the probability of response (p = 0.369 and p = 0.083,..."

Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Management of Juvenile Fibromyalgia: A Level I Evidence-Based Systematic Review. (PubMed, Med Sci (Basel)) - "Current evidence supports the use of multimodal treatment approaches in JFM. Non-pharmacological interventions, particularly when integrated with structured exercise, offer meaningful benefits with minimal safety concerns. Larger, methodologically rigorous trials are needed to establish optimal treatment pathways and long-term outcomes for this complex and underserved paediatric population."

Journal • Review • CNS Disorders • Depression • Fatigue • Fibromyalgia • Mood Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Pediatrics • Psychiatry • Rheumatology

Duloxetine, milnacipran, and pregabalin significantly reduce pain in adults with fibromyalgia. (PubMed, Recenti Prog Med) - No abstract available

Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Nonopioid Pharmacologic Management of Chronic Noncancer Pain. (PubMed, Am Fam Physician) - "For neuropathic pain, duloxetine, gabapentin, pregabalin, and high-concentration (8%) topical capsaicin provide moderate pain benefit. For fibromyalgia, pregabalin has the best evidence for moderate pain benefit, followed by the SNRIs duloxetine and milnacipran. Opioids should be considered only after other strategies have been tried and after risk-benefit assessment."

Journal • Review • Back Pain • Fibromyalgia • Immunology • Lumbar Back Pain • Musculoskeletal Pain • Neuralgia • Oncology • Osteoarthritis • Pain • Rheumatology

Third-degree atrioventricular block induced by escitalopram and quetiapine in a patient with depression: a case report. (PubMed, Am J Transl Res) - "A 70-year-old woman with a history of depression was initially treated with milnacipran and alprazolam, but the regimen was altered due to insufficient therapeutic response. This case highlights the potential for escitalopram and quetiapine to induce serious cardiac conduction abnormalities, particularly in elderly patients. Regular ECG monitoring is essential when prescribing these agents to minimize the risk of malignant arrhythmia."

Journal • Cardiovascular • CNS Disorders • Depression • Mood Disorders • Psychiatry

A Randomized Controlled Clinical Study of Minaprine Hydrochloride Tablets Monotherapy or Combined with Cognitive Behavioral Therapy in the Treatment of Refractory Cough (ChiCTR) - P=N/A | N=90 | Not yet recruiting | Sponsor: Tongji Hospital; Tongji Hospital

Monotherapy • New trial • Chronic Cough • Cough • Pulmonary Disease • Respiratory Diseases

Risk of Thrombocytopenia by SSRIs or SNRIs in Patients With Depression Based on MID-NET: A Cohort Study in Japan. (PubMed, Clin Transl Sci) - "The exposure group was categorized as each drug of SSRIs/SNRIs, SSRIs group (escitalopram, sertraline, fluvoxamine), SNRIs group (duloxetine, venlafaxine, milnacipran), or vortioxetine. The results suggest that the risk of thrombocytopenia by sertraline or fluvoxamine was comparable to that by paroxetine, known as having the risk of thrombocytopenia, leading to the revision of the sertraline package insert as a regulatory safety measure. Prescribers and clinicians may need to be vigilant to the possibility of sertraline-induced thrombocytopenia in clinical practice."

Clinical • Journal • Observational data • CNS Disorders • Depression • Hematological Disorders • Mood Disorders • Psychiatry • Thrombocytopenia