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Does Savella Cause Weight Gain?

Key Takeaways

  • Savella (milnacipran) is not commonly linked with weight gain, and some fibromyalgia patients may experience weight loss instead.
  • Weight changes can happen during treatment, but they are not usually one of the main side effects of Savella.
  • Savella is an SNRI (serotonin-norepinephrine reuptake inhibitor) that can affect appetite, energy, and sleep, which may indirectly influence weight.
  • Monitoring blood pressure, heart rate, and side effects is important because Savella can cause hypertension, palpitations, or trouble sleeping.
  • A healthcare provider can help determine whether weight gain is related to Savella, another medication, or fibromyalgia symptoms.

What Is Savella?

Savella is the brand name for milnacipran, a prescription medication approved by the FDA to treat fibromyalgia. It is sometimes grouped with antidepressant medications because it affects serotonin and norepinephrine, but Savella is not approved in the U.S. for major depressive disorder.

Savella belongs to a class called serotonin-norepinephrine reuptake inhibitors (SNRIs). These norepinephrine reuptake inhibitors affect brain chemicals involved in pain signaling and mood regulation, which may help improve symptoms of fibromyalgia such as muscle pain, fatigue, and overall function.

Is Weight Gain a Common Side Effect of Savella?

Weight gain is not considered a common side effect of Savella. In clinical trials comparing Savella to a placebo, significant weight gain was not a typical finding.

In fact, some people taking Savella experience mild weight loss, especially early in treatment. This may be related to nausea, reduced appetite, constipation, or other common side effects. However, individual responses vary, and weight changes can still happen.

Why Weight Changes Can Happen on Savella

Even when weight gain isn’t common, changes in body weight may occur for indirect reasons.

Appetite changes

Savella can affect appetite and digestion. Some people eat less due to nausea or dry mouth, while others may notice cravings or changes in eating patterns as their pain improves.

Energy and activity level

Fibromyalgia patients often reduce activity due to pain and fatigue. If Savella improves pain relief and energy, physical activity may increase, which could support weight loss. On the other hand, if symptoms flare or the medication causes drowsiness, activity may decrease.

Sleep disruption

Trouble sleeping is a possible side effect of Savella. Poor sleep can affect hunger hormones and metabolism, potentially contributing to weight gain over time.

Constipation and bloating

Constipation is a common side effect of Savella and may cause bloating that feels like weight gain. This is usually temporary and does not represent true fat gain.

Weight Gain vs Fibromyalgia-Related Weight Changes

It’s important to separate medication effects from fibromyalgia-related weight changes. People with fibromyalgia often experience weight fluctuations due to:

  • Pain-related inactivity
  • Changes in mood and appetite
  • Sleep disruption
  • Other medications used for symptoms

Medications commonly used in fibromyalgia, such as pregabalin, are more closely associated with weight gain than Savella in many patients.

Savella Compared With Other Fibromyalgia Medications

Savella is one of several FDA-approved treatment options for fibromyalgia. Other commonly used choices include:

Duloxetine

Duloxetine is another SNRI used for fibromyalgia symptoms and may cause weight changes depending on the patient and duration of use.

Pregabalin

Pregabalin is known to cause weight gain in some people due to fluid retention and appetite changes.

Because fibromyalgia patients often try multiple therapies, weight changes may reflect the overall treatment plan rather than Savella alone.

Other Side Effects to Watch For

Even though weight gain is not a major concern for most people, Savella has other side effects that require attention.

Common side effects

Common side effects of Savella include:

  • Nausea
  • Constipation
  • Dry mouth
  • Hot flush
  • Increased heart rate
  • Drowsiness
  • Trouble sleeping
  • Increased liver enzymes (not as common as the others listed)

Cardiovascular effects

Savella can raise heart rate and blood pressure. People with hypertension or high blood pressure should be monitored, and healthcare professionals may check vital signs during follow-up visits.

Possible cardiovascular effects include:

  • Tachycardia
  • Palpitations
  • Elevated blood pressure

Serious Side Effects and Safety Concerns

Savella has serious side effects that should be taken seriously.

Suicidal thoughts and psychiatric effects

Savella carries warnings about suicidal thoughts, especially in younger patients. It may also trigger mood changes in people with bipolar disorder or other psychiatric disorders.

Serotonin syndrome

Serotonin syndrome is a rare but potentially dangerous condition that can occur when serotonin levels become too high. The risk increases if Savella is combined with:

  • SSRIs or selective serotonin reuptake inhibitors
  • Tramadol or other opioids
  • Triptans
  • Linezolid
  • Supplements such as St. John’s wort
  • Amphetamines

Symptoms can include agitation, fever, rapid heart rate, sweating, and confusion. Seek medical advice immediately if symptoms occur.

Bleeding problems

Savella may increase bleeding risk when used with warfarin or other blood thinners. Always discuss drug interactions with your healthcare provider.

Low sodium (hyponatremia)

Some SNRIs are linked to low sodium levels, especially in older adults or those taking diuretics. Symptoms can include headache, weakness, and confusion.

MAOI interactions

Savella should not be used with a monoamine oxidase inhibitor or MAOI because it may lead to a serious, sometimes fatal, reaction. Symptoms include very high body temperature, rigidity, rapid fluctuations of your blood pressure and heart rate, agitation, delirium, and coma. You should not start Savella within 14 days of stopping an MAOI medication or start an MAOI within 5 days of stopping Savella.

Breastfeeding and Weight Changes

It is not fully known how milnacipran affects breastfeeding infants through breast milk. If you are breastfeeding, discuss risks and benefits with a healthcare provider before taking Savella.

What to Do If You Gain Weight on Savella

If you notice weight gain while taking Savella:

  • Do not stop the medication abruptly
  • Track when the weight changes started
  • Review changes in sleep, appetite, and activity
  • Discuss symptoms and options with your healthcare provider

A provider may assess other causes such as hormonal changes, low activity due to fibromyalgia symptoms, or another medication in your regimen.

Bottom Line

Savella is not commonly associated with weight gain, and some people experience mild weight loss instead. Still, weight changes can happen due to appetite changes, sleep disruption, constipation, and shifts in activity levels as fibromyalgia symptoms improve or worsen. If you notice significant weight gain while taking Savella, a healthcare professional can help determine the cause and adjust your treatment plan safely. You can also find more information in the Medication Guide that should come with Savella.

FAQs

Does Savella cause weight gain in most people?
Savella is not typically known for causing weight gain, and it is not listed as a common side effect in clinical trials. However, individual responses vary, and some people may still notice weight changes while taking it.

Can Savella cause weight loss instead?
Yes, some people experience weight loss, especially early on, due to nausea or reduced appetite. Weight loss is not guaranteed, but it can happen as a side effect of Savella.

Why do some fibromyalgia patients gain weight during treatment?
Weight gain can be related to fibromyalgia symptoms, reduced activity, sleep problems, or other medications like pregabalin. It’s important to look at the full treatment plan rather than blaming Savella alone.

What should I do if I gain weight while taking Savella?
Keep taking your medication unless your healthcare provider tells you to stop. Your provider can check for other causes, review drug interactions, and adjust treatment options if needed.

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