Generic Name: Levomilnacipran
Brand Names: Fetzima
Drug Class: SNRI, Anti-depressant
Similar Class Drugs: Desvenlafaxine, Venlafaxine
Available Dosage Form: Extended-release capsules
What is Levomilnacipran?
Levomilnacipran is a second-generation anti-depressant used to treat major depressive disorder in adults. It elicits antidepressive effects by inhibiting the transporters of serotonin and norepinephrine.1 The inhibition of transporters delays the uptake of both neurotransmitters and prolongs their function. Elevation in the levels of serotonin and norepinephrine impedes the progression of depressive symptoms.
Although it upregulates the levels of serotonin, Levomilnacipran has greater selectivity for norepinephrine. It has no affinity for other receptors.1 Clinical studies tested the effectiveness of Levomilnacipran in improving functional impairment (a symptom of depression). The results concluded that functional impairments markedly improved with Levomilnacipran in comparison to placebo.
How to use Levomilnacipran?
Capsules with specific dosages of the formulation are available. These have to be swallowed whole with water. Read the instructions on the leaflet provided with the packaging. Do not chew, crush or break the capsules.1 You can take it with or without food. If you have frequent stomach issues, it is better to take the capsule with food. Take the capsule in the morning or evening or in accordance with the dosage prescribed by your doctor. Try keeping a reminder that will help you in following your dosage schedule.
In case you miss your morning dose, take it as soon as you remember. But avoid overdosing if there is not enough time interval left before the second dosage. It takes a few weeks for Levomilnacipran to reach plasma levels effective enough to cause improvement. Leaving treatment without the doctor’s approval will increase the risk of side effects.
What are the side effects of Levomilnacipran?
The usual side effects noted with Levomilnacipran include:
– Decreased appetite
Side effects may vary among individuals due to differences in age, gender, severity of disease, and associated comorbidities.
The most common adverse effects caused by Levomilnacipran:2
– Raised heart rate
– Penile and sexual impairment
– Suicidal behavior
There is a potential risk for the development of suicidal tendencies, especially in children and adolescents. Depressive patients of this age group must be rigorously monitored to prevent suicides or suicidal attempts.
Who should not use Levomilnacipran?
– Hypersensitive patients
– Pregnant and breastfeeding women
– Children and adolescents
– Geriatric patients
– Patients with comorbidities
– Immunocompromised people
- Asnis GM, Henderson MA. Levomilnacipran for the treatment of major depressive disorder: a review. Neuropsychiatr Dis Treat. 2015;11:125-135. Published 2015 Jan 9. doi:10.2147/NDT.S54710
- Bruno A, Morabito P, Spina E, Muscatello MR. The Role of Levomilnacipran in the Management of Major Depressive Disorder: A Comprehensive Review. Curr Neuropharmacol. 2016;14(2):191-9. doi: 10.2174/1570159×14666151117122458. PMID: 26572745; PMCID: PMC4825949.