We highly recommend enabling Javascript while using the BlackBoxRX site.


Suicidal Idealtion

  • Milnacipran is a selective serotonin and norepinephrine re-uptake inhibitor (SNRI), similar to some drugs used for the treatment of depression and other psychiatric disorders.
  • Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.
  • Anyone considering the use of such drugs in a child, adolescent, or young adult must balance this risk with the clinical need.
  • Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in   age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.
  • Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
  • Patients of all ages who are started on milnacipran should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior.
  • Families and caregivers should be advised of the need for close observation and communication with the prescriber.
  • Milnacipran is not approved for use in the treatment of major depressive disorder. Milnacipran is not approved for use in pediatric patients.

Patient Counseling Information

Medication Guides

Patient Medication Guide

Package Inserts


Additional Information

Updated January 2018