Observational analysis confirms levomilnacipran inhibits norepinephrine, while duloxetine selectively acts on serotonin only at higher doses.
Objective: The primary aim of this study was to establish that levomilnacipran potently inhibits norepinephrine (NE) reuptake in human participants starting at a minimally efficacious regimen in major depressive disorder (MDD) and to determine the dose needed to significantly inhibit serotonin (5-HT) reuptake. The secondary aim was to confirm that duloxetine is a selective 5-HT reuptake inhibitor at its minimally effective regimen in MDD and that it significantly inhibits NE reuptake only with dose escalation.
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Nikolitch et al. (2025) studied this question.
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