There are a large number of antidepressants on the market, different substances having been synthesized in order to reduce or eliminate the typical symptoms of depressive episodes.
The different types interact at different levels and in different ways with one or more neurotransmitters, achieving more or less powerful effects and being more or less effective in certain cases. Among the great variety of these drugs that exist, in this article We are going to talk about milnacipran, a very useful SNRI antidepressant
Milnacipran is a psychotropic drug made with the purpose of combating depressive symptoms, being a medication that is part of the group of antidepressants. Among them, it is classified as a specific serotonin and norepinephrine reuptake inhibitor or IRSN.
This drug is of great help in the treatment of problems such as passivity and lack of motivation and energy that many subjects with depression show, as well as when combating cognitive symptoms. It also allows you to improve the level of concentration and attention.
Although it is a medication approved and used in much of the world, the truth is that not all countries have the same approved indications, since authorities in different regions have considered that there is not enough data on its effectiveness in specific disorders. However, it is taken into account that it generates benefits in the treatment of both depression and other problems the main one being fibromyalgia.
Milnacipran is an SNRI, a serotonin and norepinephrine reuptake inhibitor. This means that its main mechanism of action is based on preventing presynaptic neurons from reabsorb part of the neurotransmitters they have secreted (in this case, specifically serotonin and norepinephrine), so that said neurotransmitter remains available in the synaptic space for longer. Thus, it causes higher concentrations of norepinephrine and serotonin in the brain.
An aspect worth highlighting about milnacipran is that it has a greater effect at the noradrenergic than serotonergic level (in a ratio that some studies indicate is 3:1), something unusual in most antidepressants. This characteristic is shared with another psychotropic drug, which in fact has arisen from milnacipran and is its enantiomer (same chemical components, but rotated): levomilnacipran
Disorders in which it is used
Milnacipran is a psychotropic drug whose properties make it useful in different disorders and pathologies. The properties of this drug make it appropriate for the treatment of major depression, in which it has similar efficacy to that of venlafaxine (another SNRI) or SSRIs. It is especially useful in the treatment of subjects who present passivity and with little mobility and energy, used in moderate and severe depression. It has also been applied to anxious depression and disorders such as generalized anxiety disorder.
Likewise, various studies have shown that milnacipran is also very useful in the treatment of medical problems that involve chronic pain, such as fibromyalgia. In this last disorder, it contributes to producing an improvement both in terms of reducing pain and the cognitive symptoms that usually accompany fibromyalgia. It also seems to improve the mobility of subjects who suffer from it.
Curiously, although we are dealing with a substance with antidepressant effects, In the United States, its application in the treatment of major depressive disorder is not approved In that country, milnacipran is approved only for the treatment of fibromyalgia. On the other hand, in much of Europe (including Spain) milnacipran does not have a specific indication for fibromyalgia, but it does have a specific indication for depression.
Despite these differences, the truth is that those affected by both types of condition (which can also occur together) have shown an improvement in symptoms, being applied in clinical practice in both one and the other.
Side effects and risks
As with most drugs and psychotropic drugs, the consumption of milnacipran can be very useful for a large number of people, but sometimes can cause side effects unpleasant and even pose a risk to some people
Some of the most common side effects are hyperhidrosis or excessive sweating, nausea and vomiting, dizziness and hot flashes, blurred vision, constipation, urinary difficulties or decreased libido. Other more serious side effects are the possibility of tachycardia and hypertension, decreased blood sugar levels, and liver problems. It has also been seen that in some severe cases it can cause seizures.
It has also been seen that in some people with bipolar disorder, it can lead to a manic episode, as well as exacerbate hallucinations and delusions in patients with psychotic disorders. Although some studies seem to indicate that it is not frequent, it can also facilitate the appearance of suicidal thoughts.
Regarding contraindications, pregnant or lactating women should not take milnacipran, as well as in minors. It is contraindicated in people with heart problems (especially those who have recently suffered a heart attack) and kidney problems, as well as narrow-angle glaucoma or urinary problems. Finally, it is contraindicated if the subject follows treatment with MAOI antidepressants, as their combination could generate serotonin syndrome.
