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Re: Everything You Ever Wanted To Know About Savella

Posted by mtdewcmu on January 2, 2010, at 13:55:17

In reply to Re: Everything You Ever Wanted To Know About Savella, posted by SLS on December 26, 2009, at 17:20:45

> > My own opinion...this drug is probably a potent workhorse in combinations with SSRIs or antipsychotics, though by itself it is plenty impressive.
>
> To paraphrase something you said in an earlier post, if it were so impressive, you would hear more about it and see more people using it.
>
> I have my doubts about milnacipran. However, I will not overlook it or exclude it from consideration. It might be that this drug has not been made visible enough to clinicians as an antidepressant.
>
>
> - Scott

Going by that study by Cipriani, et al, it appears that the effectiveness of SNRIs is inversely related to their preference for norepinephrine over serotonin. So,

Effexor > Savella > Cymbalta > Reboxetine

It seems that serotonin has a far greater influence on depression.

The preferences for serotonin from high to low:

Effexor: 116
Savella: 9.15
Cymbalta: 7.23
Reboxetine: 0.121

-from Goodman & Gilman.

Efficacy according to Cipriani, et al, from high to low:

Effexor: 1.28
Savella: 1.01
Cymbalta: 0.99
Reboxetine: 0.68

The numbers are relative to Prozac.


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URL: http://www.dr-bob.org/babble/20091227/msgs/932139.html