Jose G. Veliz, M.D. M.S.A.
Medical Director
Palomar Pain Management Center
Pomerado Pain Management Center
Posted May 7, 2009 10:03 AM
A multicenter, double-blind, placebo-controlled study was performed to evaluated the efficacy and tolerability of Milnacipran in treating fibromyalgia. A significant number of Milnacipran-treated patients with fibromyalgia noted improvements in pain, physical function and fatigue. The doses used were 100 and 200 mg/per day. The decreased pain response to Milnacipran began as early as one week after the start of treatment and was sustained throughout the study.
The most common side effect was nausea. Other, less common, side-effects included constipation, hot flush, dizziness, palpitations, hypertension, increased heart rate and migraine.
Of the above mentioned side effects, nausea often resolves - especially when Milnacipran is taken with food and the dose is gradually increased.
Milnacipran is classified as a norepinephrine-serotonin reuptake inhibitor, but with greater selectivity for norepinephrine compared to serotonin. This is consistent with the finding that, in patients with fibromyalgia, there are decreased levels of norepinephrine and serotonin in the central nervous system.
Reference: Clauw D J, Mease P, et al. Milnacipran for the Treatment of Fibromyalgia in Adults: A 15-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Multiple-Dose Clinical Trial. Clinical Therapeutics. Blind-30, Number 11.
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