As you see in the link below, milnacipran, or Savella, made by Cypress Bioscience, Inc., has recently been approved for the treatment of fibromyalgia. Savella has been in use in Europe for many years now, so it is not a new drug. This is good news, indeed!
Both serotonin and norepinephrine have been shown to modulate pain processing. In people with fibromyalgia, lower levels of serotonin and norepinephrine metabolites are seen in the spinal fluid. Savella blocks the reuptake of both norepinephrine and serotonin to similar degrees. This raises the serum levels of both of these neurotransmitters. It is therefore similar to the tricyclic antidepressants, for example amitryptilene and nortriptylene, except that it doesn't inhibit cholinergic, histamine, and alpha-adrenergic pathways, so there are fewer side effects. Notably, Savella's ability to increase available norepinephrine helps combat some of the fatigue seen with fibromyalgia. Savella can be taken along with Lyrica. The clinical trial data show that Savella is significantly better than placebo for the treatment of fibromyalgia pain. I will share my clinical experience with this medication in this blog in the months to come.
Patients have been asking me about and for Savella recently. Because of its similarity to antidepressants, you may have to stop your antidepressant before starting Savella, but Savella already has an anti-depressant effect.
Both serotonin and norepinephrine have been shown to modulate pain processing. In people with fibromyalgia, lower levels of serotonin and norepinephrine metabolites are seen in the spinal fluid. Savella blocks the reuptake of both norepinephrine and serotonin to similar degrees. This raises the serum levels of both of these neurotransmitters. It is therefore similar to the tricyclic antidepressants, for example amitryptilene and nortriptylene, except that it doesn't inhibit cholinergic, histamine, and alpha-adrenergic pathways, so there are fewer side effects. Notably, Savella's ability to increase available norepinephrine helps combat some of the fatigue seen with fibromyalgia. Savella can be taken along with Lyrica. The clinical trial data show that Savella is significantly better than placebo for the treatment of fibromyalgia pain. I will share my clinical experience with this medication in this blog in the months to come.
Patients have been asking me about and for Savella recently. Because of its similarity to antidepressants, you may have to stop your antidepressant before starting Savella, but Savella already has an anti-depressant effect.
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