Side Effects of milnacipran: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Milnacipran is an FDA-approved medication for fibromyalgia. 22 Studies have shown that milnacipran can effectively reduce pain and improve other symptoms associated with fibromyalgia. 22 Milnacipran is thought to work by affecting the brain's pain pathways through its action as a serotonin and norepinephrine reuptake inhibitor. 20 Furthermore, milnacipran has been reported to have fewer side effects compared to other antidepressants. 1 However, it is important to note that milnacipran can still cause side effects in some patients.

Reasons for Side Effects

Milnacipran works by blocking the reabsorption of serotonin and norepinephrine. These neurotransmitters play crucial roles in various functions such as mood, sleep, and appetite. By blocking their reabsorption, milnacipran increases their levels in the brain, which can lead to side effects in some individuals. 11

Common Side Effects

Nausea

Nausea is a frequent side effect of milnacipran. 8 It was reported in 43.5% of patients receiving placebo and in 71.7% of those taking milnacipran. 8

Headache

Milnacipran can cause headaches. Studies have shown that headaches were significantly more common among individuals taking milnacipran. 1

Drowsiness

Milnacipran can cause drowsiness. 27 This side effect is likely due to milnacipran's inhibition of serotonin reuptake. 27

Constipation

Constipation is another possible side effect of milnacipran. 10 This might occur because milnacipran can slow down bowel movements. 10

Dry Mouth

Milnacipran may cause dry mouth. 10 This could be attributed to a decrease in saliva production caused by milnacipran. 10

Rash

A rash is a potential side effect of milnacipran. 10 This is usually an allergic reaction to milnacipran. 10

Sexual Dysfunction

Sexual dysfunction can occur as a side effect of milnacipran. 18 This might be related to milnacipran's inhibition of serotonin reuptake. 18

Weight Gain

Weight gain is a possible side effect of milnacipran. 10 This could be due to an increased appetite caused by milnacipran. 10

High Blood Pressure

Milnacipran can cause high blood pressure. 12 This may occur due to milnacipran's inhibition of norepinephrine reuptake. 12

Tachycardia

Milnacipran can cause tachycardia (rapid heart rate). 12 This may also be caused by milnacipran's inhibition of norepinephrine reuptake. 12

Countermeasures for Side Effects

Nausea

To reduce nausea, eating small meals slowly and staying hydrated is recommended. 8

Headache

Headaches usually lessen as you continue taking milnacipran. However, if you experience severe headaches, consult your doctor.

Drowsiness

Drowsiness usually subsides as you continue taking milnacipran. 27 If drowsiness is severe, consult your doctor. 27

Constipation

To prevent constipation, a diet rich in fiber and adequate hydration are crucial. 10

Dry Mouth

Dry mouth can be alleviated by drinking water. 10

Rash

If you develop a rash, stop taking milnacipran and consult your doctor immediately. 10

Sexual Dysfunction

Sexual dysfunction usually lessens over time as you continue taking milnacipran. 18 However, if you experience severe sexual dysfunction, consult your doctor. 18

Weight Gain

To prevent weight gain, maintaining a healthy diet and regular exercise are recommended. 10

High Blood Pressure

High blood pressure requires proper medical management under your doctor's guidance. 12

Tachycardia

Tachycardia usually subsides as you continue taking milnacipran. 12 If tachycardia is severe, consult your doctor. 12

Comparison Between Studies

Commonalities Between Studies

Many studies have demonstrated that milnacipran is effective in treating fibromyalgia. 8 Moreover, milnacipran has been shown to have fewer side effects compared to other antidepressants. 1

Differences Between Studies

The frequency and specific types of side effects associated with milnacipran can vary across different studies. 8 These differences might be attributed to variations in the patient populations and research methodologies. 8

Precautions for Applying Research to Real Life

While milnacipran has been proven effective for fibromyalgia, it is important to remember that it can cause side effects. 22 Always follow your doctor's instructions carefully and take milnacipran as prescribed.

Limitations of Current Research

Research on the side effects of milnacipran is still ongoing. 8 Further research is particularly needed to investigate long-term side effects. 8

Future Research Directions

Future research on milnacipran's side effects should focus on understanding long-term side effects and the frequency of side effects in diverse patient populations. 8 Moreover, research is needed to develop strategies for mitigating the side effects of milnacipran. 8

Conclusion

Milnacipran is a valuable treatment option for fibromyalgia but it is essential to be aware of its potential side effects. 22 Always consult your doctor and follow their instructions for safe and effective treatment. While research on milnacipran's side effects is ongoing, further studies are needed to comprehensively understand its long-term effects and to develop strategies to minimize side effects. 8

Literature analysis of 28 papers
Positive Content
24
Neutral Content
1
Negative Content
3
Article Type
1
1
1
9
28
1.

Lower side effects of milnacipran than paroxetine in the treatment of major depression disorder among Han Chinese in Taiwan.

Author: ChangTing-Ting, LêngChhian-Hui, WuJo Yung-Wei, LeeSheng-Yu, WangYu-Shan, ChenYi-Chyan, LuRu-Band

Depression treatment
Side effects

Milnacipran, a dual-action antidepressant, showed similar efficacy to paroxetine in treating major depressive disorder. Milnacipran was associated with fewer side effects such as headache, tremor, and psychomotor retardation compared to paroxetine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

The Role of Vitamin D in the Management of Chronic Pain in Fibromyalgia: A Narrative Review.

Author: HaddadHannah W, JumonvilleAllison C, StarkKatarina J, TempleShavonne N, DikeChukwudum C, CornettElyse M, KayeAlan D

Fibromyalgia treatment

Fibromyalgia (FM) is a chronic pain disorder. This narrative review examines the evidence regarding vitamin D for the treatment of FM.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

The Cardiovascular Effects of Newer Antidepressants in Older Adults and Those With or At High Risk for Cardiovascular Diseases.

Author: BehlkeLauren M, LenzeEric J, CarneyRobert M

Depression treatment
Cardiovascular side effects

Depression is a common mental health condition that can affect people of all ages, including older adults. While selective serotonin reuptake inhibitors (SSRIs) are often the first-line treatment for depression, many patients do not respond to these medications. This review summarizes what is known about the cardiovascular side effects of some of the newer antidepressants, including venlafaxine, desvenlafaxine, duloxetine, milnacipran, levomilnacipran, mirtazapine, bupropion, vilazodone, vortioxetine, agomelatine, moclobemide, and ketamine-esketamine. While some of these drugs may be safe and effective alternatives for older adults and patients with cardiovascular disease, more research is needed to fully understand their safety and efficacy in these patient populations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Electroacupuncture reduces fibromyalgia pain by downregulating the TRPV1-pERK signalling pathway in the mouse brain.

Author: HsuHsin-Cheng, HsiehChing-Liang, LeeKun-Ta, LinYi-Wen

Pain relief

Acupuncture has been recommended by the World Health Organization as a method for pain relief. This article discusses the potential use of acupuncture as an alternative treatment for fibromyalgia (FM) pain, which can be treated with duloxetine, milnacipran, and pregabalin, but these drugs have undesirable side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Side effect profile and comparative tolerability of 21 antidepressants in the acute treatment of major depression in adults: protocol for a network meta-analysis.

Author: TomlinsonAnneka, EfthimiouOrestis, BoadenKatharine, NewEmma, MatherSarah, SalantiGeorgia, ImaiHissei, OgawaYusuke, TajikaAran, KishimotoSanae, KikuchiSino, ChevanceAstrid, FurukawaToshi A, CiprianiAndrea

Major depression treatment
Adverse events

This study presents a protocol for a network meta-analysis comparing the efficacy, adverse events, and tolerability of all second-generation and selected first-generation antidepressants in the acute treatment of major depression in adults. The study aims to extend previous findings and update the evidence base for antidepressant treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Role of ASIC3, Nav1.7 and Nav1.8 in electroacupuncture-induced analgesia in a mouse model of fibromyalgia pain.

Author: YenLiang-Ta, HsuYu-Chan, LinJaung-Geng, HsiehChing-Liang, LinYi-Wen

FM pain reduction

Electroacupuncture (EA) was found to reverse mechanical hyperalgesia and reduce ASIC3, Nav1.7, and Nav1.8 protein levels in a mouse model of fibromyalgia pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Probable Serotonin Syndrome and Withdrawal Symptoms Caused by Milnacipran.

Author: KoshiishiToru, OkuyamaKiyoshi

Depression treatment
Serotonin syndrome
Withdrawal syndrome

This case report describes a 70-year-old woman who developed serotonin syndrome and withdrawal symptoms after discontinuing milnacipran, a serotonin-norepinephrine reuptake inhibitor (SNRI). The symptoms resolved when milnacipran was replaced with mianserin, highlighting the potential risks associated with SNRI discontinuation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Japanese

14.

The serotonergic system in the neurobiology of depression: Relevance for novel antidepressants.

Author: KöhlerStephan, CierpinskyKatharina, KronenbergGolo, AdliMazda

Improved cognition
Reduced anxiety
Side effects

This review explores the role of serotonin receptors in depression and the potential of new antidepressants that target these receptors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Neuronal and immunological basis of action of antidepressants in chronic pain - clinical and experimental studies.

Author: MikaJoanna, ZychowskaMagdalena, MakuchWioletta, RojewskaEwelina, PrzewlockaBarbara

Antidepressant efficacy
Chronic pain treatment
Antidepressant side effects

Tricyclic antidepressants (TCAs) are often used to treat chronic pain, but they can have significant side effects. This review examines the evidence for the efficacy and safety of various antidepressants, including TCAs, tetracyclic antidepressants (TeCAs), serotonin and noradrenaline reuptake inhibitors (SNRIs), and atypical antidepressants, for the treatment of neuropathic pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Fluoxetine versus other types of pharmacotherapy for depression.

Author: MagniLaura R, PurgatoMarianna, GastaldonChiara, PapolaDavide, FurukawaToshi A, CiprianiAndrea, BarbuiCorrado

Depression treatment

Fluoxetine, an antidepressant, has been studied in numerous randomized controlled trials (RCTs) compared to other conventional and unconventional antidepressants. This review aims to provide specific and clinically useful information regarding the effects of fluoxetine for depression compared to other antidepressants, including tricyclics (TCAs), SSRIs, serotonin-noradrenaline reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and newer agents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

18.

Reports of sexual disorders related to serotonin reuptake inhibitors in the French pharmacovigilance database: an example of underreporting.

Author: TrenqueThierry, MauraGéric, HerlemEmmanuelle, ValletCatherine, SoleElodie, AurichePascal, DrameMoustapha

Sexual disorders

Sexual disorders were associated with the use of SRI antidepressants, milnacipran, fluvoxamine, paroxetine, venlafaxine, fluoxetine, citalopram and sertraline.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Levomilnacipran (F2695), a norepinephrine-preferring SNRI: profile in vitro and in models of depression and anxiety.

Author: AuclairA L, MartelJ C, AssiéM B, BardinL, HeuslerP, CussacD, MarienM, Newman-TancrediA, O'ConnorJ A, DepoortèreR

Anti-depressive/anti-stress activity
Locomotor side effects

LVM is a potent, selective inhibitor of NE and 5-HT transporters with preferential activity at the former. It is efficacious in models of anti-depressive/anti-stress activity, with minimal potential for locomotor side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Evaluation of the neurological safety of epidural milnacipran in rats.

Author: LimSeung Mo, ShinMee Ran, KangKyung Ho, KangHyun, NahmFrancis Sahngun, KimBaek Hui, ShinHwa Yong, LimYoung Jin, LeeSang Chul

Neuropathic pain management
Neurotoxicity

This study examined the neurotoxicity of epidural milnacipran in rats. No neurotoxicity was observed, suggesting that epidural administration of milnacipran may be safe.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Drug interaction in psycho-oncology: antidepressants and antineoplastics.

Author: MiguelC, AlbuquerqueE

Drug interactions

This review analyzed the potential drug interactions between antidepressants (ADs) and antineoplastic agents (ANs) in cancer patients. The overlapping biotransformation pathways increase the risk of interaction, potentially reducing drug efficacy or increasing side effects. Careful selection of safe and effective ADs is crucial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Prevention of poststroke depression with milnacipran in patients with acute ischemic stroke: a double-blind randomized placebo-controlled trial.

Author: TsaiChing-Shu, WuChen-Long, ChouShih-Yong, TsangHin-Yeung, HungTai-Hsin, SuJian-An

PSD prevention

Milnacipran is a safe and effective medication for preventing poststroke depression (PSD) in patients who have suffered a stroke. In a double-blind, randomized, placebo-controlled trial involving 92 patients, milnacipran significantly reduced the incidence of depression, with only 2.22% of patients in the milnacipran group developing PSD compared to 15.22% in the placebo group.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

28.

Novel antidepressants and panic disorder: evidence beyond current guidelines.

Author: SerrettiAlessandro, ChiesaAlberto, CalatiRaffaella, PernaGiampaolo, BellodiLaura, De RonchiDiana

Reduced panic symptoms

A review of 14 studies on the efficacy and side effects of novel antidepressants for panic disorder found limited evidence for the effectiveness of mirtazapine, reboxetine, milnacipran, and duloxetine. While these drugs showed some promise in preliminary studies, further research is warranted to confirm their efficacy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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