Levomilnacipran: uses and side effects of this drug

Psychoactive drugs such as escitalopram, olanzapine or diazepam are relatively well known by part of the population, either by this name or by their different trademarks. These are different drugs that treat various disorders and disorders.

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

• Related article: "Types of antidepressants: characteristics and effects"

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 Compare it with the differences between our left and right hands, which have the same shape but different orientation), their molecules being rotated to the left. left.

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

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

• Related article: "Psychoactive drugs: drugs that act on the brain"

Mechanism of action

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

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

• Related article: "Types of neurotransmitters: functions and classification"

In which cases is it used?

Levomilnacepran is an antidepressant whose main indication is treatment of major depression, being 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 reluctance and demotivation.

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

However, despite the fact that the drug from which it is derived, milnacepra, is used in the treatment of fibromyalgia, levomilnacepran does not have this indication.

Side effects

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

Generally, these side effects usually include nausea, vomiting, sweating, headaches, tachycardia or irritability. Urinary problems such as urination difficulties, symptoms typical of the cold and sometimes (although it is not usual) erectile dysfunction or difficulties in ejaculation. Hyper or hypotension, visual disturbances or weakness, insomnia and testicular pain could also appear.

In a much more serious way, one of the most relevant secondary symptoms is the possible appearance or increase of suicidal ideation, especially in the first moments and if it is a first use of antidepressants.

could also appear hallucinations and seizures. Finally, although it occurs rarely and is generally due to an interaction between this drug and other antidepressants or medicines, one of the most serious risks is the possible appearance of a syndrome serotonergic.

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

contraindications

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

They must be especially careful and consult whether or not those people who present heart disease, high blood pressure, glaucoma, liver or kidney disease, urinary problems such as obstructions, seizures, hemophilia or coagulation problems or low levels of sodium in the body.

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

People with a history of suicide attempts should also not take this medication, as suicidal ideation could be worsened. Regarding pregnant and lactating, also have contraindicated this drug. The use of this drug in patients with other mental disorders, such as bipolar disorder, should be discussed with the doctor.