Levomilnacipran (Fetzima™) for the treatment of major depressive disorder

Levomilnacipran (Fetzima ™ ) was approved by the United States Food and Drug Administration (FDA) in July 2013 for the treatment of Major Depressive Disorder (MDD) in adults. Levomilnacipran is the (1S,2R) enantiomer of racemic milnacipran and represents one of the newest medications designed and marketed as an enantiomer of an already approved medication with hopes of improving efficacy and limiting side effects. This article reviews the evidence supporting the use of milnacipran for MDD, examines the clinical studies behind levomilnacipran's approval, and discusses practical considerations regarding the use of this new antidepressant medication.