For a rather long time doctors did not recognize the existence of such disease as fibromyalgia, considering complaints of patients as manifestations of mental health disorder. It is a terrible disease, which is associated with symmetric or asymmetric pain in various parts of the patient’s body, making him suffer practically all the time. The main paradox was that it was completely unclear, whether the pain is caused by some psychological factors or depression and similar problems in patients, which are caused by the permanently aching body they have to bear. Earlier this disease was frequently misdiagnosed because old methods of examination have not shown proper results: no signs of sarcitis or osseous tissue inflammation, no symptoms of nerve disorders and manifestations of arthritis, myositis, etc. However, in recent years interest in this neurological disease has increased due to increase in the incidence rate approximately by 5%.
The first clinical studies, the purpose of which was to detect whether this is an inflammatory or psychiatric disease, couldn’t reveal any signs of inflammation. One of the theories was a possible disorder of the non-REM sleep phase and subsequent suppression of certain hormones generation. In general, now it is considered that the disease is a peculiar manifestation of a sleep disorder, however other reasons might also play an important role.
A few years ago, American researchers took a big step forwargatrod toward understanding the origins of fibromyalgia. They found out that in abnormal formations of the microvasculature, called arteriolovenular anastomose (ABA), fibromyalgia patients have an abnormally large number of very sensitive nerve endings. The function of ABA is to regulate blood supply and temperature. The researchers suggested that it was the increased sensitivity of these structures, which caused pain and impairment of blood supply to organs and human's body systems.
So, it is a problem characterized by a chronic diffuse muscular-skeletal ache in various parts of the human's body, stiffness of movements, fatigue and weakness, depressions, insomnia.
In case of insufficient treatment actions, fibromyalgia significantly reduces the patient's ability to function and affects the quality of his life, resulting in a deterioration of adaptability to external conditions, especially in society.
Previously this disease therapy included such drugs as Lyrica (pregabalin), Cymbalta (duloxetine) as well as drugs against nerve pain and epilepsy and other serotonin noradrenaline reuptake inhibitors.
Today fibromyalgia therapy includes low-dose antidepressants. These are medications which include such key substance as Milnacipran, inhibiting the reverse neuronal seizure of serotonin and norepinephrine.
- One of these medicines is Savella (Milnacipran), manufactured by Cypress Bioscience company.
- The drug containing Milnacipran is used to manage the fibromyalgia symptoms in adults.
- Milnacipran is widely used against depressions.
However, this agent has been approved by FDA to cure fibromyalgia. In the course of the research it was revealed that based on a certain scheme of taking this substance, it was possible to achieve abatement, reduction of the depressive state, improvement of the quality of life, and reduction of fatigue and anxiety.
Pharmacokinetic properties of this remedy provide for its perfect absorbability from the gastro-intestinal tract. It starts working regardless the food intake. Also it does not produce tranquilizing effects and even improves sleeping without affecting cognitive functions, which allows this remedy to be taken while attending office. It ought to be mentioned that this remedy is secure for those people who use cardiac agents as it absolutely safe for cardiac conduction system as well as for arterial blood pressure.
How to take?
- When receiving maintenance therapy it should be taken in the amount of 50 mg twice a day during the main meal. The maximum single dose is 100 mg twice a day. The maximum daily dose of the drug is 200 mg.
- However, it should be remembered that the treatment with this drug and its dosage should be strictly controlled by a doctor.
- In case you missed taking the next dose of these tablets, you have to take it immediately.
- In case the time of the next dose administration has come, take it in a normal way without changes. Do not take two doses of the remedy at once.
Adverse drug reactions
As any other medicine, this one has its own adverse reactions. The most frequent are mild dizziness and drowsiness.
In elderly people, there may be such adverse reactions as:
- Retching, constipation
- Excessive sweat
- Increase in arterial blood pressure
- Retention of urination
In addition, there may be such undesirable manifestations as: respiratory affection, peripheral edema, tachycardia, obscuration of vision.
This is an incomplete range of adverse reactions, so when treating this product, tell your doctor about all unusual conditions, for example aggressiveness, irritability, anxiety or self-injurious ideation or suicide.
In case of overdose, you must immediately seek medical aid. Overtreatment symptoms may involve excessive drowsiness, slow heartbeats, syncope and bradypnea (or interruption of breathing).
It is necessary to inform the attending physician about using non-steroidal anti-inflammatory medications treating ache, inflammatory arthropathia or edema. These agents include Aspirin, Ibuprofen, Diclofenac, Indomethacin and some other. Simultaneous administration of Savella with above-mentioned agents can cause bleeding, violation of cogitativity and other reactions.
Prescription and over-the-counter agents, vitamins and herbal remedies also may come into reaction with Milnacipran. Within the therapy course with this medication, it is strictly forbidden to drink alcohol as this increases the risk of such adverse reactions as drowsiness and dizziness, which can be dangerous.
In addition, in order to avoid any undesired reactions and manifestations, one should refrain from driving a car, complicated equipment or doing dangerous activities.
After the termination of short-term and long-term treatment with Savella, some patients had the following withdrawal symptoms: asomnia, cephalgia, sickness, psychic tension and diarrhoeal disease.
It's important! The combination of Milnacipran with lithium-based drugs and drugs of MAO inhibitors group is prohibited due to the chance of mortality.
Allergic reaction to the main substance – Milnacipran is a contraindication for administration of this agent.
Moreover, there are some other contraindications, which include:
- Renal insufficiency
- Manic depression
- Low level of sodium in the blood
- Alcohol addiction
Studies of Milnacipran impact on fetus have never been performed that is why it is absolutely not recommended using this agent during pregnancy. Also it is believed that it is better to withdraw from treatment immediately as soon as woman reveals her pregnancy.
It is forbidden to take Savella during breastfeeding. And also it must not be given to persons under the age of 18.
After the analysis, the scientists came to the conclusion that the probability of the disease development in women is 10 times higher than in men. And to be more accurate, fibromyalgia is most often diagnosed in women aged 25-60 years.
Clinical researchers registered two times more improvements in patients taking Savella comparing to those taking a placebo. Those positive developments were registered in measurements of ache, lassitude and psychic condition.
Prior to FDA approval, in-patient studies of 1.500 patients fixed improvements in the majority of those who were administering Savella. 30% reduction in ache has been registered in patients taking Savella comparing to those who used placebo. They have estimated their condition as better or much better.
Recent studies have confirmed the effectiveness of certain psychiatric drugs in fibromyalgia treatment, especially when the cause is completely incomprehensible and not necessarily similar to psychogenic factors. One explanation for this is that ache is the response of the cerebrum, and psychiatric substances usually affect the cerebrum.
Store tablets in a cool place; keep it away from direct sunlight. Also keep it away from children and pets. Do not freeze the remedy.
Never use remedy beyond their expiration date.
Disposal of this remedy has to be performed in accordance with local legislation
Many doctors involved in fibromyalgia treatment consider this remedy as really helpful, effective and good tool to manage pain in patients who could not relieve the pain with other typical pharmaceutical products.
Below please find a few statements by patients and specialists:
Neuropathologist: This remedy gave unexpected result in treating long-term pain in one of my patient. Of course, we are not talking about getting rid of this problem, but it really relieved the pain and improved quality of life of my patient. It was just necessary to correct dosing and finally we got positive result. However, it is necessary to admit that this product has a rather wide list of possible adverse reactions which have to be taken into consideration when prescribing it. However I believe that under supervision and control of a specialist positive and stable results are achievable.
Alex: I used to use usual non-steroid drugs but with no any special result. The doctor appointed Savella 50 mg two times a day. The pain was relieved greatly.
Sara: I'm pleased with the result. Now the pain does not haunt me all the time.
Ida: The drug reduces my pain, but I have some adverse reactions. I have got dizziness and nauseous.
Theresa: My physician recommended me to use this product but I am afraid to start because of too big list of adverse reactions…
Carolina: I suffer from this disease already for 5 years and nothing could anesthetize my pain as effective as these tablets. My physician recommended to start with 100 mg two times a day and later we decreased this dose up to 50 mg. twice a day. I am really satisfied with it!