Effexor (generic: venlafaxine) is one of the newer drugs available to treat depression. Structurally different from other antidepressants, it affects two neurotransmitters (chemical messengers to the brain) involved in depression: serotonin and norepinephrine. Approved for use in the United States at the end of 1993, its novel chemical action and low incidence of side effects make it a significant addition to the range of drugs used to treat depression.

How is Effexor different from other antidepressants?

Effexor is a chemically unique antidepressant drug. Like the newer class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and setraline (Zoloft), it affects the absorption of serotonin. In addition, Effexor acts on the norepinephrine system. No other available drug affects both neurotransmitters without causing the side effects of the older tricyclic antidepressants.

Are there other advantages of Effexor?

Effexor is less likely to induce seizures, to have toxic effects on the heart, and to cause lethal reactions.

For what kind of patient would Effexor be appropriate?

Effexor is recognized as a front line option (that is, first time drug for patients who have recently become ill with depression, whether they are hospitalized or treated on an outpatient basis. It can also be useful for patients who have had long-standing depressive illness and have not responded adequately to previous treatments. Almost 40 percent of so-called refractory patients (those who have not had positive results from past treatment) have had success with Effexor. Patients who have benefited from other antidepressants but have had less than complete success may want to discuss switching to Effexor with their health professionals.

How long does it take to work?

Like most other drugs used for depression, Effexor may take several weeks before it is fully effective. It is important to give the drug sufficient time before judging whether it will work for a given person. There is evidence, however, that Effexor may take effect more quickly than other antidepressants.

Can Effexor be taken with other drugs?

Effexor does not interact significantly with many other drugs, including lithium, diazepam (Valium), and cimetidine (Tagamet, an anti-ulcer drug). However, patients taking cimetidine who have high blood pressure or liver disease or are elderly should use caution in taking Effexor because the interaction can be more pronounced when these disorders are present.

Effexor definitely should not be taken at the same time as the MAOIs (such as Parnate or Nardil). Interactions with these compounds could be lethal. Patients who have been taking an MAOI and are switching to Effexor must allow sufficient time (usually 14 days) for the MAOI to clear out of the body. The same time should be allowed if changing from Effexor to an MAOI. However, switching from Effexor to other drugs is easy because Effexor is quickly removed from the body.

What is the standard dose?

The dose range is generally between 75 and 375 mg per day. The average effective dose is about 125 to 150 mg per day. Higher doses are necessary for sicker patients. It is recommended that the total dose be divided into two or three doses per day and taken with food. Dosage adjustments for elderly people are not usually necessary.

Will Effexor work for everyone?

No. Everyone responds to drugs differently. Effexor will work well for some people, and not so well for others. It is important to give the drug a trial of several weeks and to be in close communication with your health professional about signs of effectiveness, side effects, and personal factors affecting one’s response to the drug.

Category
Antidepressant
Anti-anxiety agent
antipanic agent
Description
Venlafaxine (ven-la-FAX-een) is used to treat mental depression. It is also used to treat certain anxiety disorders or to relieve the symptoms of anxiety. However, it usually is not used for anxiety or tension caused by the stress of everyday life. Venlafaxine is also used to treat panic disorders.
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For venlafaxine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to venlafaxine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in pregnant women. However, when pregnant rats were given venlafaxine in doses much larger than the usual human dose, some of their pups died before or soon after birth. Before taking this medicine, make sure your doctor knows if you are pregnant (especially if it is the third trimester) or if you may become pregnant.

Breast-feeding—This medicine passes into breast milk and may cause unwanted effects. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of this medicine with your doctor.

Children—Venlafaxine must be used with caution in children with depression. Studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine. More study is needed to be sure venlafaxine is safe and effective in children.

Older adults—In studies done to date that have included elderly people, venlafaxine did not cause different side effects or problems in older people than it did in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking venlafaxine, it is especially important that your health care professional know if you are taking the following:

Buspirone (e.g., BuSpar) or
Bromocriptine (e.g., Parlodel) or
Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], or imipramine [e.g., Tofranil]) or
Dextromethorphan (cough medicine) or
Levodopa (e.g., Sinemet) or
Lithium (e.g., Eskalith) or
Meperidine (e.g., Demerol) or
Nefazodone (e.g., Serzone) or
Pentazocine (e.g., Talwin) or
Selective serotonin reuptake inhibitors (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) or
Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
Sumatriptan (e.g., Imitrex) or
Tramadol (e.g., Ultram) or
Trazodone (e.g., Desyrel) or
Tryptophan—Using these medicines with venlafaxine may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome; symptoms of this syndrome include confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching; if you experience these symptoms contact your doctor as soon as possible
Clozapine (e.g., Clozaril)—Taking venlafaxine with clozapine may increase amounts of clozapine in the body which could cause serious unwanted effects including seizures.
Moclobemide (e.g., Manerex)—Taking moclobemide and venlafaxine together or less than 3 days apart may increase the chance of developing serious unwanted effects, including the serotonin syndrome, and is not recommended
Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])— Do not take venlafaxine while you are taking or within 2 weeks of taking an MAO inhibitor ; if you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, and severe convulsions; at least 14 days should be allowed between stopping treatment with an MAO inhibitor and starting treatment with venlafaxine, and at least 7 days should be allowed between stopping treatment with venlafaxine and starting treatment with an MAO inhibitor
Warfarin (e.g., Coumadin)—Taking venlafaxine with warfarin may increase the chance of developing serious unwanted effects.
Other medical problems—The presence of other medical problems may affect the use of venlafaxine. Make sure you tell your doctor if you have any other medical problems, especially:

Bipolar disorder (mood disorder with alternating episodes of mania and depression) or risk of—May make condition worse. Your doctor will check you for this condition.
Brain disease or damage, or mental retardation or
Seizures (history of)—The risk of seizures may be increased
Dehydration—Venlafaxine may cause serious problems in patients who are dehydrated.
Glaucoma or
Pressure within the eye—Venlafaxine may cause abnormal dilation of the pupil or other eye problems in these patients.
Heart disease or
High or low blood pressure—Venlafaxine may make these conditions worse
Heart attack or
Heart failure or
Hyperthyroidism (overactive thyroid)—Venlafaxine may cause an increase in heart rate and should be used with caution in these patients.
Kidney disease or
Liver disease or
Cirrhosis of the liver—Higher blood levels of venlafaxine may occur, increasing the chance of side effects; your doctor may need to adjust your venlafaxine dose.
Mania (history of)—The risk of developing mania may be increased
Weight loss—Venlafaxine may cause weight loss; this weight loss is usually small, but if a large weight loss occurs, it may be harmful in some patients
Proper Use of This Medicine
Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

You may have to take venlafaxine for 4 weeks or longer before you begin to feel better . Also, you will probably need to keep taking this medicine for at least 6 months, even if you feel better, to help prevent your depression from returning. Your doctor should check your progress at regular visits during this time.

Venlafaxine should be taken with food or on a full stomach to lessen the chance of stomach upset. However, if your doctor tells you to take the medicine a certain way, take it exactly as directed. If you are taking the extended-release capsule dosage form, swallow the capsule whole with fluid ; do not break, crush, chew, or place the capsule in liquid.

Dosing—The dose of venlafaxine will be different for different patients. Follow your doctor’s orders or the directions on the label . The following information includes only the average doses of venlafaxine. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on your special needs .

For mental depression:
For oral extended-release capsule dosage form:
Adults—At first, 75 milligrams (mg) a day, taken in one dose in the morning or evening. Your doctor may increase your dose if needed. However, the dose is usually not more than 225 mg a day.
Children—Use and dose must be determined by your doctor.
For oral tablet dosage form:
Adults—At first, a total of 75 mg a day, taken in smaller doses two or three times during the day. Your doctor may increase your dose if needed. However, the dose is usually not more than 375 mg a day.
Children up to 18 years of age—Use and dose must be determined by your doctor.
For anxiety:
For oral extended-release capsule dosage form:
Adults—At first, 75 mg a day, taken in one dose in the morning or evening. Your doctor may increase your dose if needed. However, the dose is usually not more than 225 mg per day.
Children—Use and dose must be determined by your doctor.
For panic disorder:
For oral extended-release capsule dosage form:
Adults—At first, 37.5 mg a day, taken in one dose in the morning or evening for 7 days. Your doctor may increase your dose if needed. However, the dose is usually not more than 225 mg per day.
Children—Use and dose must be determined by your doctor.
Missed dose—If you are taking the tablet form of venlafaxine and you miss a dose , take it as soon as possible. However, if it is within 2 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you are taking the extended-release capsule form of venlafaxine and you miss a dose , take it as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

Keep out of the reach of children.
Store away from heat and direct light.
Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
 

July 9, 2006: Group Criticizes Effexor Maker for Failure to Warn
The Medical Accountability Network, a private nonprofit organization dedicated to ethical issues in medicine, criticized Effexor maker Wyeth Pharmaceuticals for failing to adequately warn about the risk of ‘homicidal ideation’ associated with Effexor use. ‘Homicidal ideation’ (homicidal thoughts) was added to the Effexor label in November 2005, as one of the drug’s rare adverse events. The Medical Accountability Network says that the warning was not well-publicized, and that Wyeth failed to send letters to doctors or issue warning labels announcing the change.

July 2006: FDA Says Combined Use of Effexor and Migraine Medicines Risky
The U.S. Food and Drug Administration (FDA) issued an alert concerning Effexor use. The FDA announced the risks associated with the combined use of selective serotonin reuptake inhibitors (SSRIs, such as Effexor) and triptans (used to treat migraine headaches). Combined use can lead to a life-threatening condition called serotonin syndrome. Click here to read more from the FDA.

June 30, 2005: Suicidality in Adults Being Treated with Antidepressant Medications
The FDA issued a public health advisory announcing that several recent scientific publications suggested the possibility of an increased risk for suicidal behavior in adults being treated with antidepressant medications, including Effexor. The FDA advised that adults taking antidepressants (particularly those being treated for depression) should be watched closely for worsening depression and increased suicidality. Monitoring these patients is especially important when treatment beings and when doses are increased or decreased. The FDA is working closely with antidepressant manufacturers to fully evaluate the risk of suicidality in adults treated with these medications. Click here to read more.

October 15, 2004: FDA Warns of Suicidality in Child and Adolescent Antidepressant Patients
The FDA issued a public health advisory directing all antidepressant drug manufacturers to revise their products’ labeling to include boxed warning and expanded warning statements that alert healthcare providers to an increased risk of suicidality (suicidal thinking and behavior) in children and adolescents being treated with these medications. Wyeth Pharmaceuticals, the manufacturer of Effexor, has since added a black box warning to the Effexor website in response to the FDA advisory.
 

I took 225mg of effexor (you need to get to a high enough dosage for both the serotonin and norepinephrine effects to be activated. It was a much better match for me and I was able to feel both not depressed and not emotionally numb.

As for side effects, I still was about 10 lb over weight and had a decrease in sexual desire. I did discuss these side effects with my doctor. However, I accepted these as the trade off for stabilizing my depression.

I tried to see a therapist the whole time i was on these drugs, as the combination of both drugs and therapy is said to be most effective. After a complete year on at the 225 dosage, I decided to get off the effexor and try to handle any lingering depression with the new skills I learned in therapy.

Coming off effexor sucks, but is do-able. The key is to do it slowly…little by little.
I reduced my dosage by either 25 or 12.5 mg (I forget) every 4 days. The whole taper took about a month. Side effects included nausea, an electric tingling, and very intense dreams. However, these effects were tolerable and usually subsided after an hour. Taper off the drug very slowly…it is the only way to do it.

I’ve been off any anti depressant for 5 months. I still go to therapy and keep a stash of anti-anxiety pills (lorazapam) lying around in case some bad feeling pop up. I feel much better and think being on the anti depressant was a necessary step to get me here. I’ve effortlessly lost the 10 lbs I gained and have had my libido return.

OK, this is just one person’s experience, but I hope it helps somebody else with similar experiences.
Feel free to ask me any questions on this message board.
John

Depression is more than just “feeling sad.” Some common symptoms of depression include:

Changes in sleep (sleeping too much or not enough)
Eating too much or too little (and weight gain or weight loss)
Having little interest in things that you used to enjoy
Physical pain
Feeling hopeless or worthless
Suicidal thoughts.
In large clinical trials, Effexor has been proven to help adults with depression. However, it is important keep in mind that many antidepressants (including Effexor) take several weeks to begin working. Sometimes, other people will notice an improvement in your depression symptoms before you do. Often, the physical symptoms of depression (such as pain or changes in sleep) will improve first, sometimes within the first few weeks of treatment. It usually takes at least four to six weeks before significant changes in mood occur. It is important to give Effexor a chance to work before becoming discouraged.

Counseling and therapy (see Psychotherapy for Depression) are often used along with antidepressant medication to treat depression. Ask your healthcare provider if counseling or therapy would be good options for you (see Depression Treatment).

Effexor is part of a class of drugs called serotonin-norepinephrine reuptake inhibitors, or SNRIs for short. SNRIs, such as Effexor, act on two specific chemicals within the brain, known as serotonin and norepinephrine. Serotonin and norepinephrine are two of several chemicals used to send messages in between nerves; but, when serotonin and norepinephrine levels become unbalanced, it can cause a variety of conditions, such as depression. Effexor helps to block the reuptake of serotonin and norepinephrine, so that higher levels of these chemicals are available for the nerves in the brain, returning the serotonin and norepinephrine back to their “normal” levels.

Although it is not entirely clear how Effexor works for nerve pain, it appears that Effexor seems to help block the nerve pain signals in the spinal cord or brain. This helps to relieve the pain of peripheral diabetic neuropathy.

How Effexor Xr Works?

Effexor Uses in Children
Effexor is not approved for the treatment of childhood depression. Talk with your healthcare provider about the risks and benefits of using Effexor in children with depression.

Off-Label Effexor Uses
On occasion, your healthcare provider may recommend Effexor for treating something other than the conditions listed above. This is called an “off-label” use. Off-label Effexor uses can include the treatment of:

Diabetic neuropathy or other neuropathic pain
Fibromyalgia
Generalized anxiety disorder (GAD)
Hot flashes during menopause
Migraines (see Effexor and Migraine Headaches)
Obesity
Obsessive-compulsive disorder (OCD)
Social anxiety disorder (social phobia).

Storage

Store Effexor XR at room temperature (68F to 77F or 20C to 25C). Keep Effexor XR away from children.

Overdose

Seek emergency medical attention if an overdose is suspected. Symptoms of an Effexor XR overdose may include dizziness, drowsiness, numbness, nausea, irregular heartbeats, seizures, and unconsciousness.

More Information

Use caution when driving, operating machinery, or performing other hazardous activities. Effexor XR may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness, dizziness, and confusion Do not stop taking Effexor XR without first talking to your doctor. Your doctor may need to gradually reduce the dose before stopping the medication completely. Stopping the medication suddenly may cause unpleasant side effects to occur.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, (cheap price for,buy,order on low cost) is made in regards to this information.

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Effexor XR is a potent inhibitor of the reuptake of serotonin and norepinephrine-two neurotransmitters thought to play important roles in the pathophysiology of depression. Correcting the imbalance of these two chemicals may help relieve symptoms of depression.

How Taken

Effexor XR comes as a capsule to take by mouth. It is usually taken once a day and should be taken with food. Each capsule should be swallowed whole with fluid and not divided, crushed, chewed, or placed in water, or it may be administered by carefully opening the capsule and sprinkling the entire contents on a spoonful of applesauce. This drug/food mixture should be swallowed immediately without chewing and followed with a glass of water to ensure complete swallowing of the pellets(buy cheap Effexor).

Warnings/Precautions

Before starting Effexor XR, tell your doctor about any medicines you’re taking, including over-the-counter drugs and herbal supplements. If you take MAOIs you should not take Effexor XR. If you are taking antidepressants you should be watched closely for signs that your condition is getting worse or that you are becoming suicidal, especially when you first start therapy, or when your dose is increased or decreased. You should also be watched for becoming agitated, irritable, hostile, impulsive,order Effexor online, or restless. Such symptoms should be reported to your doctor right away. Effexor XR may raise blood pressure in some patients, so blood pressure should be monitored regularly. When you suddenly stop using or quickly lower your daily dose of Effexor XR, discontinuation symptoms may occur. Talk to your doctor before discontinuing or reducing your dose of Effexor XR. Pregnant or nursing women shouldn’t take any antidepressant without consulting their doctor. Until you see how Effexor XR affects you, be careful doing such activities as driving a car or operating machinery. Avoid drinking alcohol while taking Effexor XR,low cost,discount pills.

Missed Dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

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