{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:41:25Z","timestamp":1792536085019,"version":"4.5.0"},"reference-count":43,"publisher":"Journal of Biological Methods","issue":"1","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HPR"],"abstract":"<jats:p>Purpose of review\nThis is a comprehensive review of the literature regarding the use of milnacipran in treating fibromyalgia. A chronic pain disorder with other system disturbances, fibromyalgia is often resistant to many therapeutic approaches. This review presents the background, evidence, and indications for using milnacipran as a treatment option for this condition.\nRecent Findings\nThe definition of fibromyalgia has evolved over many years as it is a relatively tricky syndrome to measure objectively. Today, it is characterized by chronic, widespread pain accompanied by alterations in sleep, mood, and other behavioral aspects. A variety of therapeutic regimens currently used to treat the syndrome as a singular approach are rarely effective.\nMilnacipran is one of three drugs currently approved by the FDA for the treatment of fibromyalgia. It acts as a serotonin and norepinephrine reuptake inhibitor, which results in decreased pain transmission. Milnacipran remains an effective treatment option for fibromyalgia in adults and needs to be further evaluated with existing therapeutic approaches.\nSummary\nFibromyalgia is a broad-spectrum disorder primarily characterized by chronic pain coupled with disturbances in cognitive functioning and sleep. The progression of this syndrome is often debilitating and significantly affects the quality of life. Milnacipran is one of three FDA-approved drugs used to alleviate the symptom burden and is comparatively more therapeutic in specific domains of fibromyalgia. A more holistic approach is needed to treat fibromyalgia effectively and further research, including direct comparison studies, should be conducted to fully evaluate the usefulness of this drug.<\/jats:p>","DOI":"10.52965\/001c.25532","type":"journal-article","created":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T23:15:57Z","timestamp":1627859757000},"page":"1","source":"Crossref","is-referenced-by-count":29,"title":["Milnacipran for the Treatment of Fibromyalgia\u00a0"],"prefix":"10.14440","volume":"9","author":[{"given":"Harshit","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brook","family":"Girma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"S. Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"E. Kaufman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"A. Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"D.  Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5574","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1097\/j.pain.0000000000001819","article-title":"A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies","volume":"161","author":"Francis Creed","year":"2020","journal-title":"Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1872-6623","issn-type":"print"},{"issue":"2","key":"ref2","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/S1090-3801(02)00072-1","article-title":"Childhood adversities in patients with fibromyalgia and somatoform pain disorder","volume":"7","author":"Katrin Imbierowicz","year":"2003","journal-title":"European Journal of Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1090-3801","issn-type":"print"},{"issue":"12 SUPPL.","key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.09.008","article-title":"Pathophysiology of Fibromyalgia","volume":"122","author":"Laurence A. Bradley","year":"2009","journal-title":"American Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9343","issn-type":"print"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/6541798","article-title":"Current and Emerging Pharmacotherapy for Fibromyalgia","volume":"2020","author":"Roie Tzadok","year":"2020","journal-title":"Pain Research and Management","ISSN":"https:\/\/id.crossref.org\/issn\/1203-6765","issn-type":"print"},{"issue":"4","key":"ref5","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s11916-016-0556-x","article-title":"Fibromyalgia Pathogenesis and Treatment Options Update.","volume":"20","author":"Steven Chinn","year":"2016","journal-title":"Current pain and headache reports","ISSN":"https:\/\/id.crossref.org\/issn\/1534-3081","issn-type":"print"},{"issue":"1-2","key":"ref6","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.pain.2009.05.014","article-title":"Treatment of fibromyalgia syndrome with gabapentin and pregabalin--a meta-analysis of randomized controlled trials.","volume":"145","author":"Winfried H\u00e4user","year":"2009","journal-title":"Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1872-6623","issn-type":"print"},{"issue":"1","key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010292","article-title":"Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome","volume":"2013","author":"Winfried H\u00e4user","year":"2013","journal-title":"Cochrane Database of Systematic Reviews","ISSN":"https:\/\/id.crossref.org\/issn\/1469-493X","issn-type":"print"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010292","article-title":"Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome","author":"W. 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Arnold","year":"2019","journal-title":"Journal of Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1528-8447","issn-type":"print"},{"issue":"7","key":"ref21","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1016\/s0028-3908(98)00083-5","article-title":"Effect of acute, short- and long-term milnacipran administration on rat locus coeruleus noradrenergic and dorsal raphe serotonergic neurons.","volume":"37","author":"R Mongeau","year":"1998","journal-title":"Neuropharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3908","issn-type":"print"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"S25","DOI":"10.1097\/00004850-200206001-00004","article-title":"Pharmacology and pharmacokinetics of milnacipran.","volume":"17 Suppl 1","author":"Christian Puozzo","year":"2002","journal-title":"International clinical psychopharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/0268-1315","issn-type":"print"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/00004850-199609004-00003","article-title":"Pharmacokinetics of milnacipran in comparison with other antidepressants.","volume":"11 Suppl 4","author":"C Puozzo","year":"1996","journal-title":"International clinical psychopharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/0268-1315","issn-type":"print"},{"issue":"2","key":"ref24","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1007\/BF03189352","article-title":"Pharmacokinetics of milnacipran in renal impairment.","volume":"23","author":"C Puozzo","year":"1998","journal-title":"European journal of drug metabolism and pharmacokinetics","ISSN":"https:\/\/id.crossref.org\/issn\/0378-7966","issn-type":"print"},{"issue":"12","key":"ref25","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1097\/AJP.0b013e31828440ab","article-title":"A 3-Year, Open-Label, Flexible-Dosing Study of Milnacipran for the Treatment of Fibromyalgia","volume":"29","author":"Lesley M. 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Behlke","year":"2020","journal-title":"CNS Drugs","ISSN":"https:\/\/id.crossref.org\/issn\/1179-1934","issn-type":"print"},{"issue":"4","key":"ref28","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1177\/0091270009346059","article-title":"Effects of milnacipran on cardiac repolarization in healthy participants.","volume":"50","author":"Antonia Periclou","year":"2010","journal-title":"Journal of clinical pharmacology","ISSN":"https:\/\/id.crossref.org\/issn\/1552-4604","issn-type":"print"},{"issue":"2","key":"ref29","doi-asserted-by":"publisher","first-page":"398","DOI":"10.3899\/jrheum.080734","article-title":"The efficacy and safety of milnacipran for treatment of fibromyalgia. A randomized, double-blind, placebo-controlled trial","volume":"36","author":"Philip J. 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A data-mining analysis of baseline and outcome variables","volume":"32","author":"Lilia Abtroun","year":"2016","journal-title":"Clinical Journal of Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1536-5409","issn-type":"print"},{"issue":"3","key":"ref32","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1093\/rheumatology\/keq354","article-title":"Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: A systematic review with meta-analysis","volume":"50","author":"Winfried H\u00e4user","year":"2011","journal-title":"Rheumatology","ISSN":"https:\/\/id.crossref.org\/issn\/1462-0324","issn-type":"print"},{"issue":"6","key":"ref33","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.jpain.2010.01.002","article-title":"Comparative Efficacy and Harms of Duloxetine, Milnacipran, and Pregabalin in Fibromyalgia Syndrome","volume":"11","author":"Winfried H\u00e4user","year":"2010","journal-title":"Journal of Pain","ISSN":"https:\/\/id.crossref.org\/issn\/1526-5900","issn-type":"print"},{"issue":"9","key":"ref34","doi-asserted-by":"publisher","first-page":"2745","DOI":"10.1002\/art.27559","article-title":"Efficacy and safety of milnacipran 100 mg\/day in patients with fibromyalgia: Results of a randomized, double-blind, placebo-controlled trial","volume":"62","author":"Lesley M. Arnold","year":"2010","journal-title":"Arthritis and Rheumatism","ISSN":"https:\/\/id.crossref.org\/issn\/1529-0131","issn-type":"print"},{"issue":"2","key":"ref35","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1007\/s12016-015-8509-4","article-title":"Fibromyalgia: A Critical and Comprehensive Review","volume":"49","author":"Andrea T. 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