Taking Milnacipran to Effectively Treat Fibromyalgia

Written By: Fibromyalgia Treating

Published Date: July 28, 2015 Last Edited: July 28, 2015

Along with chronic pain, fibromyalgia patients must also contend with feelings of chronic fatigue. Even if they get several hours of sleep, people with fibromyalgia may wake up feeling tired and their thinking may be impaired as if they are in a fog.

Fortunately, there are medications that have been designed to effectively address the concerns associated with fatigue. One such medication is milnacipran.

What is Milnacipran?

Milnacipran is actually an anti-depressant that is used in the treatment of fibromyalgia. It is one of three drugs that have been approved by the Food and Drug Admission to treat the chronic condition.

Milnacipran acts to help reduce the feelings of fatigue by reducing pain and it also has other positive effects on fatigue that are separate from pain relief. While it has shown to be effective in treating fibromyalgia, scientists are not sure on why it works so well.

How Milnacipran Works

This drug increases the activity of neurotransmitters in the brain. These neurotransmitters include both serotonin and norepinephrine, which work to filter pain signals traveling along the spinal cord. This means that fewer pain signals make their way to the brain, so the brain cannot signal the body to feel pain.

When these two neurotransmitters are at nerve endings, this medication latches onto their molecules and carries them back across the nerve junction.

This allows them to be used again, or recycled, to fight pain as well as prevent pain signals. Like milnacipran, other medications that increased serotonin levels were shown to be effective in relieving pain symptoms and relaxing muscles.

How Milnacipran was Approved for Treating Fibromyalgia

The approval of milnacipran to treat fibromyalgia was based on three criteria. The first criteria met was that milnacipran, sold under the brand name Savella, allowed patients to experience at least a 30% reduction in their pain.

The second measure was that patients had to rate their pain as “very much improved” or “much improved” by the drug. Lastly, when taking milnacipran, there had to be significant progress in patients physical functioning. Since the medication met all of these requirements, the FDA approved it.

Along with these improvements, those who took milnacipran showed a marked improvement about a week after starting the drug. Most patients in case studies took 100 to 200 mg of milnacipran on a daily basis.

However, the medication is usually prescribed in the lowest dose possible at first, which is 12.5 mg, then stepped up gradually. 200 mg is the highest recommended dose per day for milnacipran.

In addition to relieving pain, milnacipran also helps relieve daytime fatigue and it can help with problems such as poor memory, as well as the inability to concentrate.

Is Milnacipran Effective?

It is difficult to tell if a drug is going to work for a patient or fail to help relieve fibromyalgia symptoms in others. However, there are ways to tell if milnacipran has a chance to help relieve your fibromyalgia symptoms.

For instance, if venlafaxine, better known as Effexor or Cymbalta, helped with pain, but caused weight gain, then milnacipran may be a better drug for people with fibromyalgia.

In addition, since milnacipran isn’t a tricyclic medication, side effects like a dry mouth, weight gain and feeling sleepy the next day are usually not experienced when taking this drug.

Milnacipran Side Effects

Like most medications, milnacipran is not without its side effects. The side effects associated with it range from very mild to severe, depending on the person taking the drug.

A favorable side effect of taking it is weight reduction. Some users experienced a weight loss of one to two pounds per month. However, along with the weight reduction was a chance of increased high blood pressure and heart rate due to the fact this medication has increases levels of norepinephrine.

Other more common side effects associated with this drug included nausea, headaches, constipation, dizziness, hot flashes, insomnia, dry mouth, palpations and profuse sweating.

With continued use, especially when taken with food, the nausea usually subsided for most people. It has few interactions with other medications and the drug takes about two hours to be fully absorbed into your bloodstream.

Some of the drug’s side effects could make some fibromyalgia symptoms worse. If you have difficulty falling and/or staying asleep, especially due to having restless legs, than milnacipran should not be taken at night because it can worsen sleep.

However, it can help to reduce pain during the day, but since it causes problems with sleep, daytime fatigue may also get worse. If it does cause problems with sleep, try taking the drug a few hours earlier and inform your doctor to help prevent fatigue issues.

People that have difficulty managing high-blood pressure may not be able to take milnacipran as it can increase blood pressure. However, if it helps to reduce your pain, then your doctor may be able to re-evaluate your blood pressure medication to see if there is a better drug to help manage it or change the dosage of the one you take.

If you are already taking milnacipran and the side effects cause problems, you may need to switch to another medication. If this is the case, you should taper down the dosage slowly because it can cause withdrawal symptoms if you quit it abruptly.

Information About Milnacipran

Effectively treating fibromyalgia can sometimes be a frustrating guessing game as no two people react the same to treatments. Being better informed about your treatment options will help you and your doctor decide what is the best course of treatment for your pain, fatigue and the other fibromyalgia symptoms that you experience.