Levomilnacipran: uses and side effects of this drug

This Antidepressant drug is mainly used against major depression.

Psychotropic drugs such as escitalopram, olanzapine or diazepam are relatively well known by the population, either by this name or by their different brand names. These are different drugs that treat various disorders and alterations.

But although these are some of the best known, they are not the only ones: new drugs have been continuously developed to combat the symptoms of different mental disorders. One of them, created and used in the treatment of depression, is levomilnacipran.

Levomilnacipran: type of substance

Levomilnacipran is a relatively recent antidepressant, being synthesized and approved for use in 2013. This substance is the enantiomer of milnacipran (something like the mirror image or reflection in a mirror at the level of molecular organization, being easy to compare it with the differences between our left and right hands, which have the same shape but different orientation), being its molecules rotated to the left.

This substance is a highly effective antidepressant that is part of the SNRIs or SNRIs. is part of the SNRIs or Specific Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs).. It fights the typical symptoms of depression such as anhedonia and sad mood, but it is especially characterized by producing a great improvement in motivation and cognitive symptoms.

Thus, it contributes to improve concentration and energy level, hindering the apathy and passivity typical of many subjects suffering from depressive symptoms. Contrary to many other psychotropic drugs, it does not seem to generate relevant alterations with respect to the weight of those who take it.

Mechanism of action

As mentioned above, levomilnacipran is a specific serotonin and noradrenaline reuptake inhibitor or SNRI. This implies that its main action at neuronal level is as a serotonin and noradrenaline agonist, increasing their levels by preventing these neurotransmitters from being reabsorbed by the neuron that emitted them and increasing the time they remain accessible in the synaptic space.

In addition, the mechanism of action of levomilnacipran has a remarkable peculiarity: unlike most antidepressants, which focus on serotonin and may or may not affect other neurotransmitters secondarily or to a lesser extent, levomilnacipran has a much greater effect on noradrenaline than on serotonin (approximately 2:1 ratio). (approximately 2:1 ratio, i.e. twice as much). This action is the one that would generate an improvement at the level of energy, motivation, and concentration capacity, hindering the passivity that usually appears in depression.

In what cases is it used?

The levomilnacepran is an antidepressant whose main indication is the treatment of major depressionIt is especially effective in this disorder in reducing emotional and cognitive symptoms. It is especially useful for those cases in which there is dysfunction and decreased socialization, and lack of appetite and motivation.

At the moment no other uses have been approved, although it is admitted that it can be effective in other problems. For example, research regarding its efficacy in cases of social phobia and chronic fatigue, as well as in some anxiety disorders, could be useful. In some cases it has been used in subjects with bipolar disorder improving the situation of subjects in the depressive phase, although there is a risk of exacerbating manic phases (so it is not (so it is not recommended in these cases or at least more research is required for the rest).

However, although the drug from which it is derived, milnacepran, is used in the treatment of fibromyalgia, levomilnacepran does not have this indication.

Side effects

Although very useful in the treatment of depression, the use of levomilnacipran has a number of possible undesirable side effects. undesirable side effects.

Generally, these side effects usually include nausea, vomiting, sweating, headache, tachycardia, or irritability. or irritability. Urinary problems such as urination difficulties, typical cold symptoms and sometimes (but not usually) erectile dysfunction or ejaculation difficulties are also common. Hyper- or hypotension, visual disturbances or weakness, insomnia and testicular pain may also occur.

Much more seriously, one of the most relevant secondary symptoms is the possible occurrence or increase of suicidal ideationespecially in the first moments and if it is a first consumption of antidepressants.

Hallucinations and convulsions may also appear. Finally, although it is rare and generally due to an interaction of this drug with other antidepressants or medications, one of the most serious risks is the possible appearance of a serotonin syndrome.

This syndrome is a serious condition in which fever, convulsions, alterations of consciousness that can lead to coma and even death can occur, so it is especially important to monitor the dosage of the drug.

Contraindications

Levomilnacipran is a useful drug, but for some people it could pose a risk, which is why in some cases it is contraindicated.

Special care should be taken and people who have heart disease, hypertension, hypertension, hypertension, hypertension, or other conditions that may affect their health should be consulted. heart disease, hypertension, glaucoma, liver or kidney disease, etc.If you are allergic to levomilnacipran, urinary problems such as obstructions, seizures, hemophilia or coagulation problems or low levels of sodium in the body, you should avoid taking it.

You should avoid taking levomilnacipran if you are allergic to this medication or if you are taking another antidepressant substance, especially in the case of MAOI antidepressantsdue to the risk of serotonergic syndrome. Similarly, it should not be mixed with alcohol or other drugs. Special care should also be taken to avoid introducing methylene blue, a dye used in some medical tests and as an antiseptic in surgeries, into the body.

People with a history of suicide attempts should not take this drug either, as it could worsen suicidal ideation. As for pregnant women and nursing mothersare also contraindicated. The use of this drug in patients with other mental disorders, such as bipolar disorder, should be discussed with the physician.