Brand Name: Effexor Xr
Generic Name: Venlafaxine

VENLAFAXINE

(ven-la-FAX-een)

NEWLY DISCOVERED USES (OFF-LABEL)
Attention deficit/hyperactivity disorder (ADHD), chronic neuropathic pain, diabetic neuropathy, fibromyalgia, menopausal symptoms, migraine prevention, obsessive-compulsive disorder (OCD), panic disorder, premenstrual dysphoric disorder (PMDD), tension headache prevention

ORIGINAL USES (ON-LABEL)
Major depressive disorder, generalized anxiety disorder, social anxiety disorder, depression, social phobia

BRAND NAME
Effexor, Effexor XR

DRUG CLASS
Antidepressant (Serotonin/Norepinephrine Reuptake Inhibitor [SNRI])

DESCRIPTION
This drug is used to treat mood disorders. It works by inhibiting serotonin and norepinephrine reuptake by brain neurons. This action is helpful in increasing levels of both these neurotransmitters.

POTENTIAL SIDE EFFECTS
Headache, dizziness, insomnia, nausea, dry mouth, constipation, anorexia, abnormal ejaculation/orgasm, weakness, sweating, changes in blood pressure, chest pain, anxiety, abnormal dreams, yawning, agitation, rash, itching, decreased libido, diarrhea, vomiting, stomach upset, flatulence, urinary frequency, impotence, impaired urination, orgasm disturbance, tremor, numbness, twitching, blurred vision, ringing in ears (tinnitus), infection, chills, trauma.

CAUTIONS

• Contraindicated in the use of MAO inhibitors (such as phenelzine, tranylcypromine, isocarboxazid) within 14 days and should not initiate a MAO inhibitor within seven days of discontinuing venlafaxine.
• Inform your doctor if you have current problems or a history of problems with kidney or liver failure, increased intraocular pressure, or glaucoma.
• Risk of suicide may be increased in patients with major depression.
• Abrupt discontinuation or dosage reduction after extended therapy may lead to agitation, mood changes, nervousness, anxiety, and other symptoms. Gradually taper dosage according to doctor’s instructions.

DRUG INTERACTIONS
Buspirone, lithium, meperidine, nefazodone, selegiline, serotonin agonists, sibutramine, selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, paroxetine, etc.), trazodone, tricyclic antidepressants, haloperidol, indinavir, phenobarbital, carbamazepine, phenytoin

Concurrent use of MAO inhibitors or drugs with MAO inhibitor activity may result in serotonin syndrome; should not be used within two weeks of each other.

This drug is metabolized (activated) by a specific set of liver enzymes (cytochrome P450 enzymes 2D6, 3A4). Several other drugs interfere with these liver enzymes, and thus may increase or decrease the clearance of venlafaxine from the body, potentially increasing the risk of side effects or decreasing effectiveness. When these drugs are given in combination with venlafaxine, dosage adjustments may be needed. As these are too numerous to list, you should always check with your doctor or pharmacist prior to starting a new medication, herbal, or nonprescription product.

FOOD INTERACTIONS
Alcohol

HERBAL INTERACTIONS
Valerian, St. John’s wort, SAMe, kava kava, tryptophan

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category C. Excreted in breast milk. Do not use while breast-feeding.

SPECIAL INFORMATION
Neonates exposed to venlafaxine late in the third trimester of pregnancy have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery.

This drug has a warning regarding that both adults and children with major depression, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality), whether or not they are taking antidepressant medications. The warning recommends patients being treated with antidepressants be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose changes.