Savella

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Savella

What it is

Milnacipran is an SNRI (serotonin and noradrenaline reuptake inhibitor) that acts somewhat more on noradrenaline. In the US it is approved for fibromyalgia (as Savella); in Europe and Japan it is used for depression (as Ixel and Toledomin).

How genes come into it

Milnacipran is cleared largely unchanged by the kidneys and by glucuronidation, with little CYP involvement, so the common CYP gene differences matter little. Studies, mostly from Japan, looked at the serotonin genes HTR1A, SLC6A4 and HTR2A and at ADRA2A and BDNF for response in depression. The findings come from a few studies, and there is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Savella. Upload your DNA file to see which of these rows apply to you.

Rated evidence (5 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

HTR1A rs6295: Level 3. Efficacy: Depressive Disorder. 2.

HTR1A rs1364043: Level 3. Efficacy: Major Depressive Disorder. 1.

HTR1A rs10042486: Level 3. Efficacy: Major Depressive Disorder. 1.

MDGA2 rs1160351: Level 3. Toxicity: Major Depressive Disorder. 1.

Response (9 findings)

Studies of how well it worked in people carrying a variant.

ADRA2A rs1800544: Genotypes CC + CG are associated with increased response to milnacipran in people with Depressive Disorder as compared to genotype GG.

BDNF rs6265: Genotypes CT + TT is associated with increased clinical benefit to amitriptyline, clomipramine, duloxetine, imipramine, milnacipran or venlafaxine in people with Major Depressive Disorder as compared to genotype CC.

HTR1A rs10042486: Genotype CC is associated with increased response to fluvoxamine, milnacipran and paroxetine in people with Depressive Disorder, Major as compared to genotypes CT + TT.

HTR1A rs1364043: Genotype TT is associated with increased response to fluvoxamine, milnacipran and paroxetine in people with Depressive Disorder, Major as compared to genotypes GG + GT.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

Cymbalta (SNRIs)

Effexor (SNRIs)

Pristiq (SNRIs)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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