In July of 2013, the FDA approved a new serotonin norepinephrine reuptake inhibitor (SNRI) Fetzima (levomilnacipran) for major depressive disorder in adults only. The efficacy of Fetzima at once-daily doses of 40-120mg was established in three randomized, placebo-controlled studies in adults with MDD.
Fetzima is essentially an isomer, or put more simply, a clone of the SNRI Savella, which is approved for the treatment of fibromyalgia. The interesting thing is that Fetzima is not approved for fibromyalgia and Savella is not approved for depression. Go figure. Round up the usual suspects when it comes to the side effects of Fetzima – nausea, heart rate increase, palpitations, erectile dysfunction and other associated SNRI side effects.
There’s nothing new or novel here. Just another drug – in this case Savella – that has undergone a makeover to be marketed for depression.
The snail’s pace of neuroscience continues to hamper pharmaceutical companies in their quest to develop truly novel agents. What we don’t need is yet another SNRI poised to fuel oppositional tolerance, which places the brain in a fighting position to counter the effects of artificial serotonin and norepinephrine manipulation rendered by these antidepressants.