Savella

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Savella or milnacipran (generic drug name) is an antidepressant that is also licensed for use to treat fibromyalgia in adults.[1][2] 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.[3][4]

Theory[edit | edit source]

Evidence[edit | edit source]

Savella is an FDA-approved drug for adults with fibromyalgia,[5] with improvements in pain, sleep and more limited improvements in fatigue.

No clinical trials have been done for Savella/milnacipran in ME/CFS.

Clinicians[edit | edit source]

Risks and safety[edit | edit source]

Costs and availability[edit | edit source]

Perscription only drug.[2]

Notable studies[edit | edit source]

  • 2011, Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis[6] - (Full text)
  • 2014, Milnacipran versus other antidepressive agents for depression[7] - (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[8] - (Full text)
  • 2015, Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program[10] - (Full text)
  • 2016, The Effects of Milnacipran on Sleep Disturbance in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study[11] - (Full text)
  • 2018, Milnacipran poorly modulates pain in patients suffering from fibromyalgia: a randomized double-blind controlled study[12] - (Full text)
  • 2018, Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia[13] - (Full text)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. "Savella". Drugs.com. Retrieved January 17, 2022.
  2. 2.02.1 "Milnacipran | Prescribing information". Drugs.com. Retrieved January 17, 2022.
  3. Qureshi, Aniqa G; Jha, Saurav K; Iskander, John; Avanthika, Chaithanya; Jhaveri, Sharan; Patel, Vithi Hitendra; Rasagna Potini, Bhuvana; Talha Azam, Ahmad. "Diagnostic Challenges and Management of Fibromyalgia". Cureus. 13 (10): e18692. doi:10.7759/cureus.18692. ISSN 2168-8184. PMC 8580749. PMID 34786265.
  4. Kim, Do-Young; Lee, Jin-Seok; Park, Samuel-Young; Kim, Soo-Jin; Son, Chang-Gue (January 6, 2020). "Systematic review of randomized controlled trials for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)". Journal of Translational Medicine. 18 (1): 1–12. doi:10.1186/s12967-019-02196-9. ISSN 1479-5876. PMC 6943902. PMID 31906979.
  5. "Savella Patient Information. Reference 4035361" (PDF). FDA. 2016.
  6. Häuser, Winfried; Petzke, Frank; Üçeyler, Nurcan; Sommer, Claudia (March 2011). "Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis". Rheumatology (Oxford, England). 50 (3): 532–543. doi:10.1093/rheumatology/keq354. ISSN 1462-0332. PMID 21078630.
  7. Nakagawa, Atsuo; Watanabe, Norio; Omori, Ichiro M; Barbui, Corrado; Cipriani, Andrea; McGuire, Hugh; Churchill, Rachel; Furukawa, Toshi A (July 8, 2009). "Milnacipran versus other antidepressive agents for depression". The Cochrane database of systematic reviews (3): CD006529. doi:10.1002/14651858.CD006529.pub2. ISSN 1469-493X. PMC 4164845. PMID 19588396.
  8. Mease, Philip J.; Palmer, Robert H.; Wang, Yong (August 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". JCR: Journal of Clinical Rheumatology. 20 (4): 195–202. doi:10.1097/RHU.0000000000000103. ISSN 1076-1608.
  9. Cording, Malene; Derry, Sheena; Phillips, Tudor; Moore, R Andrew; Wiffen, Philip J (October 20, 2015). "Milnacipran for pain in fibromyalgia in adults". The Cochrane Database of Systematic Reviews. 2015 (10): CD008244. doi:10.1002/14651858.CD008244.pub3. ISSN 1469-493X. PMC 6481368. PMID 26482422.
  10. Arnold, Lesley M.; Bateman, Lucinda; Palmer, Robert H.; Lin, Yuhua (June 26, 2015). "Preliminary experience using milnacipran in patients with juvenile fibromyalgia: lessons from a clinical trial program". Pediatric Rheumatology Online Journal. 13: 27. doi:10.1186/s12969-015-0025-9. ISSN 1546-0096. PMC 4480575. PMID 26112278.
  11. Ahmed, Mansoor; Aamir, Rozina; Jishi, Zahra; Scharf, Martin B. (January 15, 2016). "The Effects of Milnacipran on Sleep Disturbance in Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study". Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. 12 (1): 79–86. doi:10.5664/jcsm.5400. ISSN 1550-9389. PMC 4702190. PMID 26414990.
  12. Pickering, Gisèle; Macian, Nicolas; Delage, Noémie; Picard, Pascale; Cardot, Jean-Michel; Sickout-Arondo, Sophia; Giron, Fatiha; Dualé, Christian; Pereira, Bruno; Marcaillou, Fabienne (August 10, 2018). "Milnacipran poorly modulates pain in patients suffering from fibromyalgia: a randomized double-blind controlled study". Drug Design, Development and Therapy. 12: 2485–2496. doi:10.2147/DDDT.S162810. ISSN 1177-8881. PMC 6089099. PMID 30127596.
  13. Welsch, Patrick; Üçeyler, Nurcan; Klose, Petra; Walitt, Brian; Häuser, Winfried (February 28, 2018). "Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia". The Cochrane Database of Systematic Reviews. 2018 (2): CD010292. doi:10.1002/14651858.CD010292.pub2. ISSN 1469-493X. PMC 5846183. PMID 29489029.

double blinded trial A clinical trial is double blinded if neither the participants nor the researchers know which treatment group they are allocated to until after the results are interpreted. This reduces bias. (Learn more: www.nottingham.ac.uk)

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