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'''Savella''' or '''milnacipran''' (generic drug name) is an antidepressant that is also licensed for use to treat [[fibromyalgia]] in adults.<ref name="drugscom-sav">{{Cite web | title = Savella |website=Drugs.com|access-date=2022-01-17|url=https://www.drugs.com/savella.html}}</ref><ref name="drugscom-miln">{{Cite web | title = Milnacipran {{!}} Prescribing information|website=Drugs.com|url=https://www.drugs.com/pro/milnacipran.html|access-date=2022-01-17}}</ref> No studies have been carried out on the effectiveness of Savella in [[ME/CFS]] patients, although off-label use of psychiatric medications in ME/CFS has generally been ineffective.<ref name="Qureshi2021">{{Cite journal | title = Diagnostic Challenges and Management of Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580749/|journal=Cureus|volume=13|issue=10| pages = e18692 | last = Qureshi | first = Aniqa G | last2 = Jha | first2 = Saurav K | last3 = Iskander | first3 = John | last4 = Avanthika | first4 = Chaithanya| last5 = Jhaveri | first5 = Sharan | last6 = Patel | first6 = Vithi Hitendra | last7 = Rasagna Potini | first7 = Bhuvana | last8 = Talha Azam | first8 = Ahmad|doi=10.7759/cureus.18692|pmc=8580749|pmid=34786265|issn=2168-8184}}</ref><ref name="Kim2020">{{Cite journal | last = Kim | first = Do-Young | author-link = | last2 = Lee | first2 = Jin-Seok | authorlink2 = | last3 = Park | first3 = Samuel-Young | authorlink3 = | last4 = Kim | first4 = Soo-Jin | author-link4 = | last5 = Son | first5 = Chang-Gue | authorlink5 = | date = 2020-01-06 | title = Systematic review of randomized controlled trials for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)|url=https://doi.org/10.1186/s12967-019-02196-9|journal=Journal of Translational Medicine|volume=18|issue=1|pages=1-12|doi=10.1186/s12967-019-02196-9|issn=1479-5876|pmc = 6943902|pmid=31906979|access-date=|quote=|via=}}</ref> ==Theory== ==Evidence== Savella is an FDA-approved drug for adults with [[fibromyalgia]],<ref name="PI">{{Cite web|url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/022256s022lbl.pdf | title = Savella Patient Information. Reference 4035361.|website=FDA| date = 2016}}</ref> with improvements in [[pain]], [[sleep dysfunction|sleep]] and more limited improvements in [[fatigue]]. No clinical trials have been done for Savella/milnacipran in [[ME/CFS]]. ==Clinicians== ==Risks and safety== ==Costs and availability== Perscription only drug.<ref name="drugscom-miln"/> ==Notable studies == *2011, Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis<ref name="Hauser2011">{{Cite journal | title = Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis| date = Mar 2011|url=https://academic.oup.com/rheumatology/article/50/3/532/1790544|journal=Rheumatology (Oxford, England)|volume=50|issue=3|pages=532–543 | last = Häuser | first=Winfried | authorlink = Winfried Häuser | last2 = Petzke | first2 = Frank | authorlink2 = | last3 = Üçeyler | first3 = Nurcan | author-link3 = | last4 = Sommer | first4 = Claudia | author-link4 = |doi=10.1093/rheumatology/keq354|pmc=|pmid=21078630|access-date=|issn=1462-0332|quote=|via=}}</ref> - [https://academic.oup.com/rheumatology/article/50/3/532/1790544 (Full text)] *2014, Milnacipran versus other antidepressive agents for depression<ref name="Nakagawa2014">{{Cite journal | title = Milnacipran versus other antidepressive agents for depression | date = 2009-07-08|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164845/|journal=The Cochrane database of systematic reviews|issue=3|pages=CD006529 | last = Nakagawa | first=Atsuo | last2 = Watanabe | first2 = Norio | last3 = Omori | first3 = Ichiro M | last4 = Barbui | first4 = Corrado| last5 = Cipriani | first5 = Andrea | last6 = McGuire | first6 = Hugh | last7 = Churchill | first7 = Rachel | last8 = Furukawa | first8 = Toshi A|doi=10.1002/14651858.CD006529.pub2|pmc=4164845|pmid=19588396|issn=1469-493X}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164845/ (Full text)] *2014, Effects of milnacipran on the multidimensional aspects of fatigue and the relationship of fatigue to pain and function: pooled analysis of 3 fibromyalgia trials<ref name="Mease2014">{{Cite journal | title = Effects of Milnacipran on the Multidimensional Aspects of Fatigue and the Relationship of Fatigue to Pain and Function: Pooled Analysis of 3 Fibromyalgia Trials| date = Aug 2014|url=https://journals.lww.com/jclinrheum/Abstract/2014/06000/Effects_of_Milnacipran_on_the_Multidimensional.4.aspx|journal=JCR: Journal of Clinical Rheumatology|volume=20|issue=4|pages=195–202 | last = Mease | first = Philip J. | author-link = | last2 = Palmer | first2 = Robert H. | authorlink2 = | last3 = Wang | first3 = Yong | authorlink3 = |language=en-US|doi=10.1097/RHU.0000000000000103|pmc=|pmid=|access-date=|issn=1076-1608|quote=|via=}}</ref> - [https://journals.lww.com/jclinrheum/Fulltext/2014/06000/Effects_of_Milnacipran_on_the_Multidimensional.4.aspx (Full text)] *2015, Milnacipran for pain in fibromyalgia in adults<ref name="Cording2015">{{Cite journal | title = Milnacipran for pain in fibromyalgia in adults| date = 2015-10-20|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481368/|journal=The Cochrane Database of Systematic Reviews|volume=2015 |issue=10|pages=CD008244 | last = Cording | first = Malene | last2 = Derry | first2 = Sheena | last3 = Phillips | first3 = Tudor | last4 = Moore | first4 = R Andrew| last5 = Wiffen | first5 = Philip J|doi=10.1002/14651858.CD008244.pub3|pmc=6481368|pmid=26482422|issn=1469-493X}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481368/ (Full text)] *2015, Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program<ref name="Arnold2015">{{Cite journal | title = Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program| date = 2015-06-26|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480575/|journal=Pediatric Rheumatology Online Journal|volume=13|issue=|pages=27 | last = Arnold | first = Lesley M. | author-link = | last2 = Bateman | first2 = Lucinda | author-link2 = Lucinda Bateman | last3 = Palmer | first3 = Robert H. | authorlink3 = | last4 = Lin | first4 = Yuhua | author-link4 = |doi=10.1186/s12969-015-0025-9|pmc=4480575|pmid=26112278|access-date=|issn=1546-0096|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480575/ (Full text)] *2016, The Effects of Milnacipran on Sleep Disturbance in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study<ref name="Ahmed2016">{{Cite journal | title = The Effects of Milnacipran on Sleep Disturbance in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study | date = 2016-01-15|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702190/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=12|issue=1 | pages = 79–86 | last = Ahmed | first = Mansoor | last2 = Aamir | first2 = Rozina | last3 = Jishi | first3 = Zahra | last4 = Scharf | first4 = Martin B.|doi=10.5664/jcsm.5400|pmc=4702190|pmid=26414990|issn=1550-9389}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702190/ (Full text)] *2018, Milnacipran poorly modulates pain in patients suffering from fibromyalgia: a randomized double-blind controlled study<ref name="Pickering2018">{{Cite journal | title = Milnacipran poorly modulates pain in patients suffering from fibromyalgia: a randomized double-blind controlled study | date = 2018-08-10|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089099/|journal=Drug Design, Development and Therapy|volume=12|pages=2485–2496 | last = Pickering | first = Gisèle | last2 = Macian | first2 = Nicolas | last3 = Delage | first3 = Noémie | last4 = Picard | first4 = Pascale| last5 = Cardot | first5 = Jean-Michel | last6 = Sickout-Arondo | first6 = Sophia | last7 = Giron | first7 = Fatiha | last8 = Dualé | first8 = Christian | last9 = Pereira | first9 = Bruno | last10 = Marcaillou | first10 = Fabienne|doi=10.2147/DDDT.S162810|pmc=6089099|pmid=30127596|issn=1177-8881}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089099/ (Full text)] *2018, Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia<ref name="SNRIs2018">{{Cite journal | title = Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia | date = 2018-02-28|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846183/|journal=The Cochrane Database of Systematic Reviews|volume=2018|issue=2|pages=CD010292 | last = Welsch | first = Patrick | last2 = Üçeyler | first2 = Nurcan | last3 = Klose | first3 = Petra | last4 = Walitt | first4 = Brian| last5 = Häuser | first5 = Winfried | author-link5 = Winfried Häuser|doi=10.1002/14651858.CD010292.pub2|pmc=5846183|pmid=29489029|issn=1469-493X}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846183/ (Full text)] ==See also== *[[Pain]] *[[Fibromyalgia drugs]] *[[Depression]] ==Learn more== *[https://www.drugs.com/savella.html Savella] - drugs.com ==References== {{reflist}} [[Category:Potential treatments]] [[Category:Serotonin-norepinephrine reuptake inhibitors]] [[Category:Analgesics]] [[Category:Antidepressants]]
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