Divalproex and Levomilnacipran Hydrochloride

• Generic Name: divalproex sodium
• Dosage Forms: tablet, film coated, extended release
• Other Brand Names: Depakote ER, Depakote Sprinkles, Depakote, Depakene, Depacon

Divalproex sodium affects chemicals in the body that may be involved in causing seizures.

Divalproex sodium is used to treat various types of seizure disorders. Divalproex sodium is sometimes used together with other seizure medications.

Divalproex sodium is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches.

Divalproex sodium may also be used for purposes not listed in this medication guide.

• Generic Name: levomilnacipran
• Dosage Forms: n.a.
• Other Brand Names: Fetzima

Treatment of major depressive disorder in adults.

APA states that effectiveness of antidepressants is generally comparable between and within classes of medications, including SSRIs, SNRIs, TCAs, MAO inhibitors, and other antidepressants (e.g., bupropion, mirtazapine, trazodone). Choose antidepressant based mainly on the following factors: patient preference; nature of prior response to medication; safety, tolerability, and anticipated adverse effects; concurrent psychiatric and medical conditions; specific properties of the medication (e.g., half-life, actions on CYP isoenzymes, other drug interactions); and cost. For most patients, an SSRI, SNRI, mirtazapine, or bupropion is considered optimal.

Fibromyalgia

Levomilnacipran is the more active 1S,2R-enantiomer of racemic milnacipran (Savella), which is FDA-labeled for use in the management of fibromyalgia.

Manufacturer states that levomilnacipran (Fetzima) is not approved for the management of fibromyalgia; efficacy and safety of the drug for this use not established.