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Milnacipran is a small molecule antidepressant classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). It acts by selectively inhibiting the reuptake of both serotonin (5-HT) and norepinephrine (NE) in the central nervous system. Milnacipran has a more balanced inhibition ratio between these two neurotransmitters compared to other SNRIs. It was developed by Pierre Fabre and first approved in France in 1996 for the treatment of major depressive disorder. In several countries including the United States and Australia, it is also approved for fibromyalgia. Milnacipran does not significantly affect dopamine or other neurotransmitter systems at therapeutic doses[5][6][7].
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