Milnacipran blocks reuptake of neurotransmitters serotonin and norepinephrine, thus increasing the availability of those neurotransmitters at neuronal synapses.
The mechanism is similar to duloxetine, which is also indicated for fibromyalgia (and major depression). It is taken orally, 100-200mg per day, and can cause side effects similar to other serotonin reuptake inhibitors (e.g. Fluoxetine).
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