milnacipran, Savella

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GENERIC NAME: milnacipran

BRAND NAME: Savella

DRUG CLASS AND MECHANISM: Milnacipran is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used for treating pain associated with fibromyalgia. It is similar to duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq). Milnacipran affects neurotransmitters, the chemicals that nerves within the brain make and release in order to communicate with one another. Neurotransmitters either travel across the space between nerves, attach to receptors on the surface of nearby nerves or they attach to receptors on the surface of the nerves that produced them. The neurotransmitters may be taken up by the nerve and released again (a process referred to as re-uptake).

Serotonin and norepinephrine are two neurotransmitters released by nerves in the brain. Milnacipran prevents the reuptake of serotonin and epinephrine by nerves after they have been released. Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by milnacipran increases the effect of serotonin and norepinephrine in the brain. The mechanism responsible for its effectiveness for treating fibromyalgia is not known but milnacipran action is thought to involve its effects on serotonin and norepinephrine in the brain. Milnacipran was approved by the FDA in January 2009.

Medically Reviewed by a Doctor on 8/15/2014



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