Milnacipran (Savella) seems to improve pain and therefore sleep in people with fibromyalgia

A relatively new drug available for people with fibromyalgia in the US – but not the UK – may not actively improve sleep, but does so by reducing pain, according to a small study in the Journal of Clinical Sleep Medicine.
A total of 15 people aged 28–72 years were split into groups. Some received milnacipran (Savella) (100mg/day) for a period of time and the others were given a pretend drug. Then the groups swapped over, in what is known as a double blind randomised controlled trial.

Doses of the drug were gradually escalated and then maintained. Measures of sleep, physical functioning and pain were taken at the start of the study and at the end of each treatment period.

Two-thirds of the volunteers showed a significant improvement in daily effect of pain and subjective sleep quality.

But people treated with milnacipran showed no significant improvements in wake after sleep onset, number of awakenings after sleep onset, and they had reduced sleep efficiency. Milnacipran did not show significant improvement in other measures of sleep.

“The data suggest that milnacipran is not sedating in most patients with fibromyalgia and improvements in sleep are likely a result of pain improvement,” the researchers conclude.

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Image credit: Pedro Ribeiro Simões