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

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

CD9, a novel potential biomarker of sarcopenia. (PubMed, Sci Rep) - "Besides, dapoxetine, levomilnacipran, and milnacipran were predicted to target CD9 through molecular docking. Our study reported for the first time that CD9 is a novel potential biomarker of sarcopenia, and targeting CD9 may be a new idea for the development of therapeutic drugs for sarcopenia."

Biomarker • Journal • Musculoskeletal Diseases • Orthopedics • Sarcopenia • CD9

Gastrointestinal adverse events associated with SNRIs: A FAERS-based pharmacovigilance study. (PubMed, J Affect Disord) - "A retrospective analysis of FAERS data from 2004 to 2024 identified 114,148 reports involving five SNRI drugs (venlafaxine, desvenlafaxine, milnacipran, levomilnacipran, and duloxetine). Descriptive analyses revealed that middle-aged (45-64 years) and elderly (65-74 years) patients were more susceptible to gastrointestinal adverse events compared to younger age groups, although the specific effects varied across different drugs and age groups. These findings highlight the significant risks of gastrointestinal AEs associated with SNRIs, underscoring the need for individualized drug selection, close monitoring, and further research into underlying mechanisms and long-term impacts."

Adverse events • Journal • CNS Disorders • Constipation • Depression • Gastroenterology • Gastrointestinal Disorder • Major Depressive Disorder • Mood Disorders • Psychiatry • Xerostomia

An Overview of the Systematic Reviews About the Efficacy of Fluvoxamine on Depression. (PubMed, Pharmaceuticals (Basel)) - "Comparisons with imipramine, clomipramine, amitriptyline, dothiepin, paroxetine, fluoxetine, citalopram, mianserin, nortriptyline, and moclobemide generally revealed no significant differences in efficacy. However, some reviews indicated that venlafaxine and mirtazapine were superior to fluvoxamine in certain outcomes, while fluvoxamine demonstrated greater efficacy than desipramine in one review. Sertraline and milnacipran showed mixed or review-quality-dependent results, with one low-quality review favoring milnacipran...While no single antidepressant was universally superior, fluvoxamine's unique pharmacological profile and favourable safety characteristics support its clinical utility. Further research is needed to explore its role in personalized treatment strategies and emerging therapeutic contexts, such as comorbid anxiety and post-traumatic stress disorder."

Journal • Review • CNS Disorders • Depression • Mental Retardation • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry

Comparison of Selective Serotonin Reuptake Inhibitors and USA Food and Drug Administration-Approved Serotonin-Norepinephrine Reuptake Inhibitors Treatments for Fibromyalgia: A Systematic Review and Network Meta-Analysis (ISPOR 2025) - "The NMA supports the therapeutic effectiveness of paroxetine, duloxetine, and milnacipran for fibromyalgia. Paroxetine, although used off-label, showed promise in improving sleep and pain. Treatment decisions should consider individual patient preferences and symptom profiles."

Retrospective data • Review • CNS Disorders • Cognitive Disorders • Depression • Fatigue • Fibromyalgia • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology

High-performance liquid chromatography-tandem mass spectrometry for simultaneous determination of 23 antidepressants and active metabolites in human serum and its application in therapeutic drug monitoring. (PubMed, Front Pharmacol) - "In this paper, we developed a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method to study simultaneously TDM and clinical pharmacokinetics of 23 antidepressants and active metabolites: sertraline, escitalopram, fluvoxamine, paroxetine, duloxetine, milnacipran, fluoxetine, venlafaxine, O-desmethylvenlafaxine, mirtazapine, trazodone, bupropion, hydroxybupropione, norfluoxetine, vortioxetine, agomelatine, mianserin, doxepine, desmethyldoxepin, clomipramine, desmethylclomipramine, amitriptyline and nortriptyline hydrochloride...Validation of the developed method was carried out based on the Chinese Pharmacopoeia guidelines for bioanalytical method validation, including assessment of specificity, calibration curves, carryover, accuracy, crosstalk, precision, stability, recovery, dilution integrity and matrix effect. The results showed that a simple, fast, reliable and specific HPLC'MS/MS method was developed and validated, and all the..."

Journal • CNS Disorders • Depression • Psychiatry

Esketamine Combined With SSRI or SNRI for Treatment-Resistant Depression. (PubMed, JAMA Psychiatry) - "Treatment with esketamine combined with an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, or vilazodone) or an SNRI (desvenlafaxine, duloxetine, levomilnacipran, milnacipran, or venlafaxine). In this retrospective comparative effectiveness study, among the study sample, incidence of mortality, hospitalizations, depressive relapses, and suicide attempts was low. The esketamine + SNRI group showed lower incidence of mortality, hospitalizations, and depressive relapses, while the esketamine + SSRI group showed a slightly lower incidence of suicidal attempts."

Journal • CNS Disorders • Depression • Mood Disorders • Psychiatry

Treatments for enhancing sleep quality in fibromyalgia: a systematic review and meta-analysis. (PubMed, Rheumatology (Oxford)) - "CBT-I is a promising treatment for enhancing sleep quality in fibromyalgia. Pharmacological treatments like pregabalin may be beneficial but should be used cautiously due to potential risks. Future research should prioritise trials focusing on sleep as a primary outcome and explore the comparative effectiveness of pharmacological treatments and CBT-I in fibromyalgia. Understanding the mechanisms linking sleep and fibromyalgia will also help guide future therapies."

Journal • Retrospective data • CNS Disorders • Fibromyalgia • Insomnia • Musculoskeletal Pain • Pain • Rheumatology • Sleep Disorder

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) for Treatment of Fibromyalgia: A Comprehensive Clinical Review. (PubMed, Psychopharmacol Bull) - "Currently, duloxetine and milnacipran are approved by the Food and Drug Administration although other agents in this drug class including venlafaxine and desvenlafaxine have been studied in the management of fibromyalgia. In addition, selective norepinephrine reuptake inhibitors, esreboxetine and reboxetine, as well as tramadol, a weak opioid mu-receptor agonist with SNRI activity have shown potential utility...Further information is needed to optimize patient selection and dosing regimens as well as elucidate the clinical factors associated with poor response. Moreover, pharmacologic agents may be combined with lifestyle changes and non-drug-based treatments to address the complex interactions of biological and psychosocial factors that facilitate disease development and persistence of symptoms."

Journal • Review • CNS Disorders • Fatigue • Fibromyalgia • Musculoskeletal Diseases • Musculoskeletal Pain • Neuralgia • Pain • Rheumatology

Milnacipran and Vanillin Alleviate Fibromyalgia-Associated Depression in Reserpine-Induced Rat Model: Role of Wnt/β-Catenin Signaling. (PubMed, Mol Neurobiol) - "Fibromyalgia (FM) patients are highly susceptible to depression. Interestingly, these effects of Miln and Van were overturned via administration of the β-catenin inhibitor, XAV939 (0.1 mg/kg, i.p., daily). In conclusion, this study outlined the antidepressant aptitude of Miln and Van through activating Wnt/β-catenin signaling in the hippocampus in reserpine-induced FM."

Journal • Preclinical • CNS Disorders • Depression • Fibromyalgia • Mood Disorders • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology