I saw this in Medscape and didn't know if anyone had heard about it, I have not. Maggie Milnacipran Seen Effective for Fibromyalgia Information from Industry FOSRENOL® (lanthanum carbonate) - Is a first-line calcium-free and aluminum-free product indicated to reduce serum phosphate in patients with ESRD. Review important findings, dosing and administration, and full Prescribing and Important Safety Information. Other Product InfoSites » NEW YORK (Reuters Health) Oct 28 - Milnacipran, an approved antidepressant in 30 countries, significantly improves pain and other symptoms of fibromyalgia, according to results of a study published in the October issue of the Journal of Rheumatology. "Fibromyalgia is a common musculoskeletal condition characterized by widespread pain, tenderness, and a variety of other somatic symptoms," Dr. Michael Gendreau, of Cypress Biosciences, San Diego, California, and colleagues write. "Current treatments are modestly effective," they note. "Arguably, the best studied and most effective compounds are tricyclic antidepressants (TCA)." The researchers examined the safety and efficacy of milnacipran, a nontricyclic compound that inhibits the reuptake of both serotonin and norepinephrine, in patients with fibromyalgia. In a double-blind, dose-escalation study, 125 fibromyalgia patients were randomly assigned to receive milnacipran twice daily, milnacipran once daily, or placebo for 3 months Patients in the three groups had a mean duration of fibromyalgia that ranged from 3.8 to 4.3 years. Seventy-two percent of the subjects completed the trial. Of those who stayed in the trial, 95% of placebo patients, 81% of milnacipran once-daily patients, and 92% of milnacipran twice-daily patients achieved dose escalation to the maximum dose of 200 mg. Significant reductions in pain, the primary endpoint, were observed in both the once-daily and twice-daily milnacipran groups. Improvement in global well-being, fatigue, and other domains were also observed. Twice-daily milnacipran was a more effective analgesic than once-daily, according to the authors. "Statistically greater improvements in pain reduction were seen in nondepressed patients versus depressed patients treated with milnacipran," Dr. Gendreau's team found. "However, this difference did not occur because milnacipran was more effective among nondepressed patients, but rather because the placebo response rate was considerable higher among depressed patients." No serious adverse events were reported. Most adverse events (88%) were rated as mild or moderate. Overall, 14.4% of patients discontinued the study due to adverse events, including seven patients (13.7%) in the twice-daily group, 10 (21.7%) in the once-daily group, and one (3.6%) in the placebo group. J Rheumatol 2005;32:1975-1985.