The Medical Letter on Drugs and Therapeutics
Levomilnacipran (Fetzima): A New SNRI for Depression
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The FDA has approved levomilnacipran (lee" voe mil na' si pran; Fetzima – Forest), a serotonin and norepinephrine reuptake inhibitor (SNRI), for treatment of major depressive disorder. Levomilnacipran is the more active enantiomer of milnacipran (Savella), which was approved in 2009 for management of fibromyalgia.1 Fetzima has not been studied in fibromyalgia.

TREATMENT OF DEPRESSION — Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, and generics), are recommended for first-line treatment of major depression. They are generally well tolerated and relatively safe. SNRIs, such as venlafaxine (Effexor, and generics) and duloxetine (Cymbalta, and generics), are also considered a first-line option for treatment of major depression, particularly for patients who also have neuropathic pain or ... more      

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