Fetzima: Uses and Effectiveness

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The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient's unique health circumstances and needs.

Fetzima medication is a prescription drug used in the treatment of major depressive disorder (MDD) in adult patients above the age of 18. The FDA approved it for this purpose in 2013. Currently, Fetzima is only available in its brand name form and there are no alternative generics.

Fetzima’s drug class is antidepressants. The active ingredient is levomilnacipran which belongs to a group of serotonin-norepinephrine reuptake inhibitors (SNRI). It treats depression by helping correct the imbalance of neurotransmitters responsible for managing moods and stress in the brain.

Here is an overview of how the drug works, the conditions it treats, instructions for use, and potential side effects.

See a doctor online to discuss your symptoms and get a diagnosis and suitable treatment.

Fetzima for Depression

Fetzima is primarily used to treat depression and it is the only function of the drug that is FDA-approved. As an SNRI, it works by preventing the reuptake (breakdown) of serotonin and norepinephrine, increasing their amount in the brain. Serotonin and norepinephrine are part of the brain’s chemical messaging system. Serotonin is responsible for mood, sleep, behavior, and memory. Norepinephrine is related to energy and alertness. Higher amounts of these chemicals in the brain will boost your mood and energy levels while reducing feelings of sadness.

Fetzima has proven effective in the treatment of depression in seven different studies [2*] . The studies used the Montgomery-Asberg Depression Rating Scale (MADRS) as a measure of depression symptoms among the study subjects (a lower MADRS score shows fewer symptoms). Across 8 weeks of treatment, subjects on Fetzima lowered their scores more than those on placebo treatment.

Off-label Uses: Fetzima for Anxiety

Fetzima can be used as an off-label treatment for anxiety. Off-label means the drug can be used to treat a condition for which it is not approved. The reason why Fetzima can work for anxiety is that it is a serotonin-norepinephrine reuptake inhibitor. The Anxiety and Depression Association of America recommends SNRIs as the first-choice treatment for generalized anxiety disorder.

When used for anxiety, Fetzima works similarly as it does in depression. It increases the levels of serotonin and norepinephrine which affect your mood among other things. Initially, your levels of anxiety may go up as the body gets used to the drug, but this gets better with more days of using the drug.

However, in certain cases when using this medication for anxiety or depression, Fetzima may cause anxiety as a side effect. If you are using the drug and you observe prolonged symptoms of anxiety like restlessness, agitation, lack of sleep, anger, and a lack of impulse control, Fetzima may not be the right medication for you. In this case, your doctor will guide you on withdrawal steps and prescribe an alternative medication.

Fetzima Dosage

Fetzima is an extended-release pill available in four strengths; 20 mg, 40 mg, 80 mg, and 120 mg. This modified release form allows the medication to stay in the body longer. It means that you only need one pill a day instead of two or three, and it also helps reduce the amount and intensity of side effects.

There is no single dosage for every patient, and the difference in the dosage depends on factors like age, the severity of the condition, and other medical conditions you could be having. Usually, patients start with the lowest dosage of 20 mg taken once daily for two days, and then the doctor increases the dosage to 40 mg daily. After that, the doctor may continue increasing the dosage every two days by 40 mg if necessary. The maximum dosage is 120 mg taken once daily.

You may have to use the drug for several months or longer depending on the progression of your depression symptoms and if the doctor finds the drug effective and not having adverse effects on you.

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Intake Recommendations

Fetzima should be taken once daily at about the same time. You can take it with or without food. In case you miss your dose, take it as soon as you remember. But if it is close to your next dose then you should skip the missed dose and take the one next on the schedule. Taking more than one dosage at a time can lead to serious side effects.

Fetzima Side Effects

Fetzima is generally well tolerated but like most antidepressants, its use can cause several side effects. Common side effects include:

  • Constipation.
  • Nausea.
  • Vomiting.
  • Heart palpitations.
  • Loss of appetite.
  • Excessive sweating.
  • Erectile dysfunction.

These side effects usually go away in a few days or a couple of weeks. If they persist beyond that, notify your doctor. Severe side effects are rare but if they occur you should seek immediate medical attention. They include:

  • Serotonin syndrome: the body has an excess accumulation of serotonin which manifests through symptoms like hallucinations, seizures, delirium, and sweating.
  • Trouble urinating.
  • Rising blood pressure indicated by headaches, difficulty breathing, vision problems, and chest pains.
  • Abnormal bleeding.
  • Sexual side effects.
  • Allergic reactions.
  • Suicidal thoughts.


Fetzima is an effective FDA-approved drug for depression though it can also be used as an off-label treatment for anxiety. It has proven to be one of the most effective drugs against major depressive disorder. However, like many other antidepressants, it should only be taken under the guidance of a doctor and you should follow the dosage instructions. It is also crucial to let your doctor know of any uncomfortable reaction you may have to the drug.


+2 sources
  1. Levomilnacipran for the treatment of major depressive disorder: a review. (2015)
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  2. Levomilnacipran for the treatment of major depressive disorder: a review. (2015)
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