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Jun 30, 2006
Effexor - experiences
by SirGan
 Effexor or Venlafaxine is a new antidepressant with a new chemical structure that does not resemble those of any currently used antidepressants. Effexor XR (Venlafaxine HCL) is a medication available to treat depression and generalized anxiety disorder .It is important to know that Effexor is not a tricyclic antidepressant or an MAO inhibitor. The fact is that everyone responds to medications differently. Effexor XR will work well for some people, and not so well for others. Several researches done in the past have shown that Venlafaxine is the most effective among six commonly prescribed antidepressants. Why it is so different from other antidepressants?Well, Effexor seems to have the relative freedom from side-effects associated with the:
· SSRIs such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine (Luvox) and
· The impact on both serotonin and norepinephrine associated with the tricyclic antidepressants [amitriptyline (Elavil), imipramine (Tofranil).
Effexor is different than other antidepressants because it contains the drug known as Venlafaxine, which is the active ingredient in Effexor, and should be prescribed only to people suffering from major depression or extreme anxiety. Interesting fact is that this drug has been successful in helping treat people with depression that have not responded to other antidepressants.
Metabolism and mechanism of actionThis drug belongs to class of antidepressants, called serotonin-norepinephrine reuptake inhibitors (SNRI). As Venlafaxine and its active metabolite have relatively short half-lives, 4 hours and 11 hours respectively, Effexor should be administered in divided does, two or three times a day. Venlafaxine is well absorbed, with peak plasma concentrations occurring approximately 2 hours after dosing. Structurally different from any other antidepressant, it affects two neurotransmitters involved in depression, serotonin and norepinephrine. Several researches have proven that this medication works by correcting the balance of two brain chemicals serotonin and norepinephrine.
Why are these substances so important? It is proven that these two chemicals help control moods, concentration, impulses, appetites, irritability and emotions.
Like most other medications used for depression, Effexor may take several weeks before it is fully effective and that’s why- it is important to give the medication sufficient time before judging whether it will work for a given person.
Before using this medicineIn deciding to use a medicine, the risks of taking the medicine must be evaluated against the good it will do. For Effexor, the following should be considered:
Every patient should tell doctor about cases of unusual or allergic reaction to Venlafaxine or about allergy to any other substances, such as foods, preservatives, or dyes.
Studies have not been done in pregnant women, but some researches have been conducted on animals and the effects are serious! That’s why- every woman should tell her doctor if she is pregnant (especially if it is the third trimester).
This medicine passes into breast milk and may cause unwanted effects.
Venlafaxine must be used with caution in children with depression because several studies have shown occurrences of children thinking about suicide or attempting suicide in clinical trials for this medicine.
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:
Effexor indications
There is no doubt- Effexor XR is recognized as an effective first-time medication for patients who suffer from depression or who have generalized anxiety disorder. It doesn’t mind are 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.
It is a fact that great percent of so-called refractory patients or those who have not had positive results from past treatment have had success with Effexor XR.
Recommended dosage
The usual starting dose is 75 milligrams a day, divided into 2 or 3 smaller doses. It should always be taken with food. If needed, your doctor may gradually increase your daily dose in steps of no more than 75 milligrams at a time up to a maximum of 375 milligrams per day.
For both depression and anxiety the usual starting dose is 75 milligrams once daily, although some people begin with a dose of 37.5 milligrams for the first 4 to 7 days. Your doctor may gradually increase the dose, in steps of no more than 75 milligrams, up to a maximum of 225 milligrams daily.
Possible side effects of EffexorSeveral researches have published warning which has been issued with Effexor and with other SSRI and SSRN anti-depressants advising of risk of suicidality. Family members should be advised of this potentially fatal side effect so they may bring the patient to a hospital emergency for surveillance and protection.
Common side effects include:
Less Common side-effects include:
Effexor and other medicationsIt is important to know that Effexor XR does not interact significantly with many other medications, including lithium, Valium (diazepam), and Tagamet (cimetidine, an anti-ulcer medication). Every patient should know that if taking Tagamet for 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. Another important thing to know is that Effexor XR definitely should not be taken at the same time as the MAOIs (Parnate or Nardil). Interactions with these compounds could be lethal.
Physical and Psychological DependenceAlthough, no researches have been conducted on human, several in vitro studies revealed that Effexor has virtually no affinity for opiate, benzodiazepine, phencyclidine (PCP), or N-methyl-D-aspartic acid (NMDA) receptors.
The fact is that there was no indication of drug-seeking behavior in the clinical trials. However, it is not possible to predict on the basis of experience the extent to which a CNS active drug will be misused, diverted, or abused once marketed.
Withdrawal symptomsEvery patient should know that Effexor may cause potentially serious withdrawal symptoms upon sudden discontinuation. These withdrawal symptoms have a tendency to be significantly stronger than the withdrawal effects of other antidepressants including the tricyclic antidepressants.
Discontinuation effects may include:
· irritability,
· hostility,
· headache,
· nausea,
· fatigue,
· dysphoria
· brain shivers
Rarer withdrawal symptoms include:
· shaking legs,
· tremor,
· vertigo,
· Abdominal or stomach pain;
· agitation;
· black, tarry stools;
· bleeding gums;
· blistering,
· peeling,
· loosening of skin;
· bloating of abdomen;
· blood in eye;
· bloody urine;
· confusion
· dizziness
· paresthesia
· impaired concentration,
· bizarre dreams,
· agitation
· suicidal thoughts
Effexor and suicideThe possibility of a suicide attempt in seriously depressed patients is inherent to the illness and may persist until significant remission occurs.
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