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What
is Effexor XR?
Effexor XR (venlafaxine HCL) is a medication available to
treat depression and generalized anxiety disorder (GAD). Structurally
different from any other antidepressant, it affects two neurotransmitters
(chemical messengers in 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 medications used to treat depression and GAD.
How
is Effexor XR different from other antidepressants?
Effexor XR is a chemically unique antidepressant medication.
Like the newer class of antidepressants known as selective
serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine)
and Zoloft (sertraline), it affects the absorption of serotonin.
In addition, Effexor XR acts on the norepinephrine system.
No other available medication affects both neurotransmitters
without causing the side effects of the older tricyclic antidepressants.
Are
there other advantages of Effexor XR?
Effexor XR is less likely to induce seizures, to have toxic
effects on the heart, and to cause lethal reactions than the
older tricyclic antidepressants.
For
what kind of patient would Effexor XR be appropriate?
Effexor XR is recognized as an effective front-line option
(that is, first-time medication) for patients who have recently
become ill with depression or who have GAD, whether they are
hospitalized or treated on an outpatient basis. It can also
be useful for patients who have had longstanding 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 XR. Patients who have benefited from
other antidepressants but have had less than complete success
may want to discuss switching to Effexor XR with their doctors.
What
about side effects?
Relatively few side effects have been reported with Effexor
XR. Those that have been noted are dose-related; that is,
side effects increase as the dose increases. Very few patients
have had to discontinue the medication because of side effects.
The most common
minor side effects during clinical trials include short-term
nausea (which can be reduced by taking the medication with
food), sleepiness, dry mouth, dizziness, constipation, nervousness,
sweating, weakness, ejaculation/orgasm problems, and loss
of appetite.
A small percentage (about five percent) of patients, usually
those taking higher doses, will develop elevated blood pressure.
Therefore, patients taking Effexor XR should have their blood
pressure checked regularly. Some agitation has been noticed
at higher dosages. Patients who stop Effexor XR
abruptly may experience dizziness, nausea, vertigo, and shock-like
symptoms. Therefore, slow tapering is recommended.
How
long does it take to work?
Like most other medications used for depression, Effexor XR
may take several weeks before it is fully effective. It is
important to give the medication sufficient time before judging
whether it will work for a given person. There is evidence,
however, that Effexor XR may take effect more quickly than
other antidepressants.
Can
Effexor XR be taken with other medications?
Effexor XR does not interact significantly with many other
medications, including lithium, Valium (diazepam), and Tagamet
(cimetidine, an anti-ulcer medication). However, patients
taking Tagamet who have high blood pressure or liver disease
or are elderly should use caution in taking Effexor XR because
the interaction may be more pronounced when these disorders
are present.
Effexor XR 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 XR 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 XR to an MAOI. However,
switching from Effexor XR to other medications is easy because
Effexor XR is quickly removed from the body.
What
is the standard dose?
The dose range is generally between 75 and 225 mg per day,
although lower and higher doses may be safe and effective.
Higher doses are necessary for those with more severe symptoms.
Effexor XR should be taken once daily. Dosage adjustments
for elderly people are not usually necessary.
Will
Effexor XR work for everyone?
No. Everyone responds to medications differently. Effexor
XR will work well for some people, and not so well for others.
It is important to give the medication a trial of several
weeks and to be in close communication with your doctor about
signs of effectiveness, side effects, and personal factors
affecting one's response to the medication.
For more in-depth information about mental illness, treatments
and supports, and medications;
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