Erowid Venlafaxine (Effexor) Vault: Basics

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Venlafaxine Basics
by Erowid

DESCRIPTION
Venlafaxine (Effexor) is an oral antidepressant. It is the first in a class of antidepressants known as the SNRI's (Serotonin, Norepinephrine Reuptake Inhibitors). It is also a weak inhibitor of the reuptake of dopamine. Venlafaxine is indicated in the treatment of depression and generalized anxiety disorder. It is structurally unrelated to known antidepressants and anxiolytics. Venlafaxine has an active metabolite, O-desmethylvenlafaxine (ODV).

Following oral administration, approx 92% of venlafaxine is absorbed (Regardless of it being an immediate release or extended release form). It is extensively metabolised in the liver and most of the parents drug and its metabolites are recovered in the urine. [PDR]
[ Main Venlafaxine Vault ]

EFFECTS
Like most antidepressants, venlafaxine takes a few days to a few weeks to manifest its effectiveness. The antidepressant effect gradually builds up in stages following oral administration. Venlafaxine reaches steady-state plasma concentrations after three days of dosing. The reason why the antidepressant effect takes two weeks to a month to manifest is unknown. The reason for venlafaxine's anxiolytic (anti-anxiety) effect is also unknown.

PROBLEMS
Many people report side effects with venlafaxine. Because venlafaxine inhibits the reuptake of norepinephrine, it has cardiovascular effects. The most disturbing of these is hypertension. If you have hypertension, please please (!!!) discuss this with both your psychiatrist and the physician managing your vascular health.

The other side effects will sound familiar to anyone who has taken antidepressant or atypical-antipsychotic medications. Venlafaxine can cause anxiety, dizziness and insomnia (which is paradoxical to its anxiolytic effect). It can also cause a decrease in appetite and, consequently, weight.

As with the SSRI's (Selective Serotonin Reuptake Inhibitors), venlafaxine may increase the risk of skin and mucous membrane bleeding. This is believed to be caused by the inhibition of reuptake of serotonin into platelets.

Suicide is a risk associated with depression and continues to be a risk until significant remission occurs. Because venlafaxine can take up to a month to become effective (and there may have to be dose adjustments following this period), psychological distress can occur before remission occurs even after treatment has been initiated.

Contraindications

Do not take venlafaxine if you are currently taking an MAOI. MAOIs are most commonly found in the prescription anti-depressants Nardil (phenelzine), Parnate (tranylcypromine), Marplan (isocarboxazid), Eldepryl (l-deprenyl), and Aurorex or Manerix (moclobemide). Ayahuasca also contains MAOIs (harmine and harmaline). Venlafaxine and MAOIs are a potentially dangerous combination. Check with your doctor if you are not sure whether your prescription medication is an MAOI.

If you have a seizure or convulsive disorder, you may be at higher risk for health problems when taking venlafaxine. It has recently come to light that venlafaxine may lower the seizure threshold.

Venlafaxine may aggravate narrow angle glaucoma.

Last Modified - Tue, Apr 24, 2007

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