National Alliance on Mental Illness
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Generic name: venlafaxine (ven la FAX een)
Medication Class: Serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
What is Effexor® and what does it treat?
Venlafaxine is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (social phobia).
Symptoms of depression include:
Generalized Anxiety Disorder (GAD) occurs when a person experiences excessive anxiety or worry for at least six months. Other symptoms include
Panic Disorder occurs when a person experiences unexpected and repeated episodes of intense fear. These episodes have physical symptoms including chest pain, shortness of breath, heart palpitations, sweating, dizziness, and nausea. Fear of future episodes is also part of panic disorder.
Social phobia/social anxiety disorder is a fear of situations where one may feel as if they are being judged by others. Symptoms include:
What is the most important information I should know about Effexor®?
Do not stop taking venlafaxine, even when you feel better. Only your healthcare provider can determine the length of treatment that is right for you.
Missing doses of venlafaxine may increase your risk for relapse in your symptoms.
Stopping venlafaxine abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania. Symptoms of mania include "high" or irritable mood, very high self esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).
Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.
Are there specific concerns about Effexor® and pregnancy?
If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the baby can be born before it is fully developed (before 37 weeks).
Caution is advised with breastfeeding since venlafaxine does pass into breast milk.
What should I discuss with my healthcare provider before taking Effexor®?
How should I take Effexor®?
Venlafaxine immediate release tablets are usually taken 2 or 3 times per day with or without food. The extended release tablets and capsules one time per day with or without food.
Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 37.5 mg to 300 mg. Only your healthcare provider can determine the correct dose for you.
Extended release tablets: swallow whole; do not chew, crush, or break
Extended release capsules: swallow whole or sprinkle onto food, such as applesauce or pudding and eat immediately.
Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
What happens if I miss a dose of Effexor®?
If you miss a dose of venlafaxine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
What should I avoid while taking Effexor®?
Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
What happens if I overdose with Effexor®?
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of venlafaxine does not exist.
What are the possible side effects of Effexor®?
Common Side Effects
These will often improve over the first week or two as you continue to take the medication.
These often do not improve over time.
Rare Side Effects
Increased heart rate, low blood pressure, increased salivation, irregular menstrual cycle, increased frequency of urination, changes in taste, increased bleeding (e.g., gums may bleed more easily), low sodium (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding, difficulty urinating
Serious Side Effects
Serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), gastrointestinal bleeding
Are there any risks of taking Effexor® for long periods of time?
To date, there are no known problems associated with long term use of venlafaxine. It is a safe and effective medication when used as directed.
What other medications may interact with Effexor®?
Venlafaxine should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azilect®), and selegeline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when venlafaxine is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), and the antibiotic linezolid (Zyvox®).
Venlafaxine may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and aspirin).
How long does it take for Effexor® to work?
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Provided by the College of Psychiatric and Neurologic Pharmacists
Summary of Black Box Warnings
Suicidal Thoughts or Actions in Children and Adults