2D 3D
	ID	DDInter1220
	Drug Type	small molecule
	Molecular Formula	C15H22N2O
	Molecular Weight	246.354
	CAS Number	92623-85-3
	Description	Milnacipran is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) and like many agents in this category was originally developed for and continues to be approved and indicated for the treatment of depression [F3928, F3934, A175786, A175951]. Furthermore, in 2009 the US FDA approved milnacipran for the additional indication of treating fibromyalgia [F3925], although other regional regulatory authorities like the EMA, among others, have not yet approved the agent for such treatment, citing lack of robust evidence of efficacy, insufficient demonstration of maintenance of effect, and other concerns [F3928, F3934]. Nevertheless, milnacipran demonstrates a somewhat unique characteristic among SNRIs to elicit a relatively balanced reuptake inhibition of both serotonin and noradrenaline, with a somewhat increased preference for noradrenaline reuptake inhibition - which is potentially a point of interest given the plausible proposal that noradrenaline plays an important role in the mitigation of pain signals in the descending inhibitory pain pathways in the brain and spinal cord [A175759, A175843, A175846]. Moreover, recent research has shown that the levorotatory enantiomer of milnacipran, levomilnacipran, may have the capacity to inhibit the activity of beta-site amyloid precursor protein cleaving enzyme-1 (BACE-1), which has investigationally been associated with β-amyloid plaque formation - making the agent a possible course of treatment for Alzheimer's disease [A175957].
	ATC Classification	N06AX17
IUPAC Name	2-(aminomethyl)-N,N-diethyl-1-phenylcyclopropane-1-carboxamide
InChI	GJJFMKBJSRMPLA-UHFFFAOYSA-N
Canonical SMILES	CCN(CC)C(=O)C1(CC1CN)C1=CC=CC=C1
Useful Links	DrugBank ChEBI PubChem Substance KEGG Drug ChemSpider BindingDB PharmGKB Therapeutic Targets Database Wikipedia ChEMBL