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What is the drug venlafaxine used for. Venlafaxine: Uses, Side Effects, and Important Information for Depression Treatment

What is venlafaxine used for. How does venlafaxine work. What are the potential side effects of venlafaxine. Who should exercise caution when taking venlafaxine. How should venlafaxine be taken for optimal results.

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Understanding Venlafaxine: A Powerful Antidepressant Medication

Venlafaxine is a widely prescribed antidepressant medication that belongs to the class of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs). This potent medication is primarily used to treat depression and has shown significant efficacy in improving mood, energy levels, and restoring interest in daily activities for many patients.

How does venlafaxine work to alleviate depression. Venlafaxine functions by helping to restore the balance of two crucial neurotransmitters in the brain: serotonin and norepinephrine. By inhibiting the reuptake of these chemicals, venlafaxine increases their availability in the brain, which can lead to improved mood regulation and emotional stability.

The Therapeutic Applications of Venlafaxine

While primarily prescribed for depression, venlafaxine has shown versatility in treating various mental health conditions. Its effectiveness extends beyond just mood improvement, making it a valuable tool in the psychiatric pharmacopeia.

  • Major Depressive Disorder (MDD)
  • Generalized Anxiety Disorder (GAD)
  • Social Anxiety Disorder (SAD)
  • Panic Disorder
  • Neuropathic pain

Can venlafaxine be used for conditions other than depression. Yes, while its primary use is for treating depression, healthcare providers may prescribe venlafaxine off-label for other conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and certain types of chronic pain syndromes.

Proper Administration and Dosage Guidelines

The correct administration of venlafaxine is crucial for its effectiveness and to minimize potential side effects. Patients should always follow their healthcare provider’s instructions carefully.

How should venlafaxine be taken. Venlafaxine is typically taken orally, usually 2 to 3 times daily with food. The dosage is based on the individual’s medical condition and response to treatment. To reduce the risk of side effects, doctors often start with a low dose and gradually increase it.

  1. Start with the prescribed initial dose
  2. Take medication consistently at the same times each day
  3. Do not skip doses or stop taking the medication without consulting your doctor
  4. If a dose is missed, take it as soon as remembered, unless it’s close to the next scheduled dose
  5. Never double up on doses to make up for a missed one

Is it necessary to take venlafaxine with food. Yes, it’s generally recommended to take venlafaxine with food. This can help reduce nausea and other gastrointestinal side effects that some patients may experience.

Potential Side Effects and Monitoring

Like all medications, venlafaxine can cause side effects. While many people tolerate the medication well, it’s important to be aware of potential adverse reactions and to report any concerning symptoms to a healthcare provider promptly.

Common Side Effects

  • Nausea
  • Drowsiness
  • Dizziness
  • Dry mouth
  • Constipation
  • Loss of appetite
  • Blurred vision
  • Nervousness
  • Insomnia
  • Excessive sweating

Do side effects of venlafaxine typically improve over time. Many patients find that side effects are most pronounced in the first few weeks of treatment and tend to diminish as the body adjusts to the medication. However, if side effects persist or worsen, it’s important to consult with a healthcare provider.

Serious Side Effects Requiring Immediate Attention

While rare, some side effects of venlafaxine require immediate medical attention:

  • Easy bleeding or bruising
  • Decreased libido or changes in sexual function
  • Muscle cramps or weakness
  • Tremors
  • Severe confusion
  • Seizures
  • Eye pain or swelling
  • Signs of serotonin syndrome (e.g., hallucinations, rapid heartbeat, fever, severe dizziness)

When should a patient seek emergency medical help while taking venlafaxine. Emergency medical attention should be sought if a patient experiences symptoms such as chest pain, shortness of breath, severe dizziness, fainting, or any signs of a severe allergic reaction (e.g., rash, itching, swelling, severe dizziness, trouble breathing).

Special Precautions and Warnings

Venlafaxine, like other antidepressants, comes with important warnings and precautions that patients and healthcare providers must be aware of to ensure safe and effective use.

Suicidality Risk in Young Adults

One of the most critical warnings associated with venlafaxine and other antidepressants is the potential increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults under 25 years old.

Why is there an increased risk of suicidal thoughts in young people taking antidepressants. The exact mechanism is not fully understood, but it’s believed that as antidepressants begin to work, they may increase energy and motivation before mood improves, potentially giving some individuals the energy to act on suicidal thoughts. This risk is highest in the first few weeks of treatment or when dosages are changed.

Monitoring for Behavioral Changes

Patients, especially those under 25, should be closely monitored for any unusual changes in behavior, worsening of depression, or emergence of suicidal thoughts. Family members and caregivers should also be alert to such changes and report them immediately to the healthcare provider.

  • Worsening depression or anxiety
  • Panic attacks
  • Insomnia or sleep disturbances
  • Irritability or mood swings
  • Aggressive or violent behavior
  • Dangerous impulsivity
  • Extreme agitation or restlessness
  • Unusual changes in behavior

Drug Interactions and Contraindications

Venlafaxine can interact with various medications and substances, potentially leading to adverse effects or reduced efficacy. It’s crucial for patients to inform their healthcare providers about all medications, supplements, and herbal products they are taking.

Medications to Avoid While Taking Venlafaxine

  • Monoamine Oxidase Inhibitors (MAOIs)
  • Other SSRIs or SNRIs
  • Triptans (used for migraine treatment)
  • Certain pain medications (e.g., tramadol)
  • St. John’s Wort
  • Lithium
  • Certain antipsychotics

Why is it dangerous to combine venlafaxine with MAOIs. The combination of venlafaxine and MAOIs can lead to a potentially life-threatening condition called serotonin syndrome, characterized by high fever, seizures, irregular heartbeat, and unconsciousness. A washout period is required when switching between these medications.

Contraindications

Venlafaxine is contraindicated in certain conditions and situations:

  • Known hypersensitivity to venlafaxine or its components
  • Use of MAOIs within 14 days before or after venlafaxine treatment
  • Uncontrolled narrow-angle glaucoma
  • Severe liver or kidney disease (may require dose adjustment)
  • Pregnancy and breastfeeding (discuss risks and benefits with a healthcare provider)

Long-Term Use and Discontinuation

Venlafaxine is often prescribed for long-term use in managing chronic depression and anxiety disorders. However, patients should be aware of important considerations regarding extended use and the process of discontinuation.

Long-Term Efficacy and Monitoring

For many patients, long-term use of venlafaxine is safe and effective in maintaining mood stability and preventing relapse of depressive episodes. However, regular monitoring is essential to assess ongoing efficacy and potential side effects.

How often should patients on long-term venlafaxine therapy be evaluated. Patients should typically have follow-up appointments at least every 3-6 months, or more frequently if needed, to assess treatment response, adjust dosage if necessary, and monitor for any emerging side effects or complications.

Discontinuation Syndrome

Abruptly stopping venlafaxine can lead to discontinuation syndrome, a set of symptoms that can occur when the medication is suddenly stopped or the dose is significantly reduced.

What are the symptoms of venlafaxine discontinuation syndrome. Common symptoms include:

  • Dizziness
  • Nausea
  • Headache
  • Fatigue
  • Irritability
  • Anxiety
  • Electric shock sensations (brain zaps)
  • Flu-like symptoms

How can discontinuation syndrome be minimized. To minimize the risk of discontinuation syndrome, venlafaxine should be tapered off gradually under the guidance of a healthcare provider. The tapering process may take several weeks or even months, depending on the individual’s dosage and response.

Venlafaxine in Special Populations

The use of venlafaxine requires special consideration in certain populations due to potential risks or altered drug metabolism.

Elderly Patients

Older adults may be more sensitive to the effects of venlafaxine and may require lower starting doses. They are also at increased risk for certain side effects, such as hyponatremia (low sodium levels) and falls due to dizziness or drowsiness.

Pregnant and Breastfeeding Women

The use of venlafaxine during pregnancy and breastfeeding is a complex decision that requires careful consideration of the potential risks and benefits.

Is it safe to take venlafaxine during pregnancy. The safety of venlafaxine during pregnancy has not been fully established. Some studies suggest a slightly increased risk of certain birth defects, particularly in the first trimester. However, untreated depression during pregnancy also carries risks. The decision to use venlafaxine during pregnancy should be made on an individual basis in consultation with a healthcare provider.

Can venlafaxine be used while breastfeeding. Venlafaxine does pass into breast milk, and its effects on nursing infants are not fully known. Some experts recommend avoiding venlafaxine during breastfeeding if possible, while others consider it acceptable if the benefits outweigh the potential risks. Close monitoring of the infant is essential if venlafaxine is used while breastfeeding.

Patients with Liver or Kidney Impairment

Venlafaxine is metabolized in the liver and excreted by the kidneys. Patients with liver or kidney disease may require dose adjustments or more careful monitoring.

How should venlafaxine dosing be adjusted in patients with liver or kidney impairment. In patients with mild to moderate liver or kidney impairment, lower doses of venlafaxine may be recommended. In severe cases, alternative treatments may be considered. Regular monitoring of liver and kidney function is important for patients on venlafaxine, especially those with pre-existing conditions.

Enhancing Treatment Efficacy: Lifestyle and Therapeutic Adjuncts

While venlafaxine can be highly effective in treating depression and anxiety disorders, its efficacy can be enhanced when combined with lifestyle modifications and complementary therapeutic approaches.

Lifestyle Modifications

Certain lifestyle changes can complement the effects of venlafaxine and contribute to overall mental health improvement:

  • Regular exercise
  • Balanced diet rich in omega-3 fatty acids
  • Adequate sleep hygiene
  • Stress reduction techniques (e.g., meditation, deep breathing exercises)
  • Limiting alcohol and caffeine intake
  • Maintaining social connections and support systems

How does exercise complement antidepressant treatment. Regular physical activity has been shown to boost mood-enhancing neurotransmitters, reduce stress hormones, and promote neuroplasticity. For many patients, combining exercise with antidepressant medication leads to better outcomes than medication alone.

Psychotherapy

Combining venlafaxine with psychotherapy, particularly cognitive-behavioral therapy (CBT), can significantly enhance treatment outcomes for depression and anxiety disorders.

Why is the combination of medication and psychotherapy often recommended. The combination approach addresses both the biological and psychological aspects of mental health disorders. While venlafaxine helps to correct chemical imbalances in the brain, psychotherapy provides tools and strategies for managing thoughts, emotions, and behaviors, leading to more comprehensive and sustainable improvement.

Alternative and Complementary Therapies

Some patients find benefit in incorporating alternative or complementary therapies alongside their venlafaxine treatment. These may include:

  • Acupuncture
  • Mindfulness-based stress reduction
  • Yoga
  • Light therapy (particularly for seasonal affective disorder)
  • Herbal supplements (under medical supervision)

Can herbal supplements be safely used with venlafaxine. It’s crucial to consult with a healthcare provider before combining any herbal supplements with venlafaxine. Some supplements, such as St. John’s Wort, can interact dangerously with antidepressants. A healthcare provider can offer guidance on safe and potentially beneficial complementary therapies.

Venlafaxine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

… Show More

Uses

Venlafaxine is used to treat depression. It may improve your mood and energy level, and may help restore your interest in daily living. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

How to use Venlafaxine HCL

Read the Medication Guide provided by your pharmacist before you start using venlafaxine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually 2 to 3 times daily with food.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as confusion, mood swings, blurred vision, headache, tiredness, sleep changes, and brief feelings similar to electric shock. Your dose may need to be gradually decreased to reduce side effects. Report any new or worsening symptoms right away.

It may take several weeks to feel the benefit of this medication. Tell your doctor if your condition lasts or gets worse.

Side Effects

See also Warning section.

Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, trouble sleeping, unusual sweating, or yawning may occur. If any of these effects last or get worse, tell your doctor promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor).

Get medical help right away if you have any very serious side effects, including: cough that doesn’t go away, shortness of breath, chest pain, severe/pounding headache, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), seizure.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking venlafaxine, tell your doctor or pharmacist if you are allergic to it; or to desvenlafaxine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, heart problems (such as heart failure, previous heart attack), high cholesterol, kidney disease, liver disease, seizure disorder, thyroid disease.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially bleeding and dizziness when standing. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Dizziness and salt imbalance can increase the risk of falling.

Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, anxiety, panic attacks) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as duloxetine/milnacipran), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Venlafaxine is very similar to desvenlafaxine. Do not take medications containing desvenlafaxine while using venlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does Venlafaxine HCL interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, fast/irregular heartbeat.

Do not share this medication with others.

Lab and/or medical tests (such as blood pressure, cholesterol) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Venlafaxine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

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Uses

Venlafaxine is used to treat depression, anxiety, panic attacks, and social anxiety disorder (social phobia). It may improve your mood and energy level and may help restore your interest in daily living. It may also decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. Venlafaxine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

How to use venlafaxine oral

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using venlafaxine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily with food, either in the morning or evening.

Do not crush, chew, or dissolve this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow whole without crushing or chewing.

If you are taking the capsules, swallow them whole. If you have trouble swallowing the capsules whole, you may open the capsule and sprinkle the contents onto a spoonful of applesauce. Swallow all of the mixture right away without chewing. Drink a glass of water after each dose.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as confusion, mood swings, blurred vision, headache, tiredness, sleep changes, and brief feelings similar to electric shock. Your dose may need to be gradually decreased to reduce side effects. Report any new or worsening symptoms right away.

It may take several weeks to feel the benefit of this medication. Tell your doctor if your condition lasts or gets worse.

Side Effects

See also Warning section.

Nausea, drowsiness, dizziness, dry mouth, constipation, loss of appetite, blurred vision, nervousness, trouble sleeping, unusual sweating, or yawning may occur. If any of these effects last or get worse, tell your doctor promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor).

Get medical help right away if you have any very serious side effects, including: cough that doesn’t go away, shortness of breath, chest pain, severe/pounding headache, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), seizure.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking venlafaxine, tell your doctor or pharmacist if you are allergic to it; or to desvenlafaxine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, personal or family history of glaucoma (angle-closure type), high blood pressure, heart problems (such as heart failure, previous heart attack), high cholesterol, kidney disease, liver disease, seizure disorder, thyroid disease.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness when standing. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics). Dizziness and salt imbalance can increase the risk of falling. Older adults may also be at greater risk for bleeding while using this drug.

Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, anxiety, panic attacks) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.

This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 7 days after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, other SNRIs such as duloxetine/milnacipran), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Venlafaxine is very similar to desvenlafaxine. Do not take medications containing desvenlafaxine while using venlafaxine.

This medication may interfere with certain lab tests (including urine tests for amphetamines), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Does venlafaxine oral interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures, fast/irregular heartbeat.

Do not share this medication with others.

Lab and/or medical tests (such as blood pressure, cholesterol) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Use of the antidepressant venlafaxine in patients with chronic pain | Kamchatnov P.R., Radysh B.B., Kutenev A.V., Kazakov A.Yu.

Use of the antidepressant venlafaxine in patients with chronic pain

September 03, 2009

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  • Kamchatnov P. R.

    1

  • ,

  • Radysh B.B.

  • ,

  • Kutenev A.V.

  • ,

  • Kazakov A.Yu.

    1

1

RNIMU them. N.I. Pirogov of the Ministry of Health of Russia, Moscow, Russia

    For citation: Kamchatnov P.R., Radysh B. B., Kutenev A.V., Kazakov A.Yu. Use of the antidepressant venlafaxine in patients with chronic pain syndrome. breast cancer. 2009;20:1382.

    Chronic pain that lasts longer than necessary for normal healing and persists for more than 12 weeks is a fairly common condition in the population. The results of a population study conducted in Europe, which included 50 thousand people, allow us to state that every fifth adult suffers from severe or moderate chronic pain [8]. It turned out that the most common causes of chronic pain syndrome are diseases of the musculoskeletal system – lesions of bones, joints, periarticular tissues. The vast majority of respondents who confirmed the presence of chronic pain receive systematic pain treatment, but more than half of them do not believe that the therapy is quite effective.

    Chronic pain that lasts longer than necessary for normal healing and persists for more than 12 weeks is a fairly common condition in the population. The results of a population study conducted in Europe, which included 50 thousand people, allow us to state that every fifth adult suffers from severe or moderate chronic pain [8]. It turned out that the most common causes of chronic pain syndrome are diseases of the musculoskeletal system – lesions of bones, joints, periarticular tissues. The vast majority of respondents who confirmed the presence of chronic pain receive systematic pain treatment, but more than half of them do not believe that the therapy is quite effective.
    A serious problem is neuropathic pain, the occurrence of which is caused by a direct lesion of the somatosensory system and is not associated with irritation of pain receptors. The results of epidemiological studies suggest that at least 3% of the members of the population experience neuropathic pain, although there are data on its wider prevalence [25]. According to modern views on the pathophysiology of neuropathic pain, the lesion that causes it can be localized at different levels of the peripheral or central nervous system [1,5]. The developing complex restructuring of the nervous system leads to the formation of a pathological algic system that ensures the existence of a persistent pain syndrome.
    An important role in the formation of neuropathic pain syndrome is played by the dysfunction of the mechanisms of perception and processing of pain impulses [4]. Of great importance is also a decrease in the activity of the body’s own anti-pain systems, in particular, the pathways emanating from the nuclei of the brain stem (in particular, the periaqueductal gray matter), the neurotransmitters in which are serotonin and norepinephrine [19]. Violation of the functioning of this system is of great importance for the occurrence of chronic pain syndromes due to various reasons.
    Taking into account the complex pathophysiological mechanisms of the formation of chronic pain, neuropathic pain syndromes, painkillers (for example, paracetamol) and non-steroidal anti-inflammatory drugs are not always effective for their relief. Moreover, their extremely low efficacy in true neuropathic pain has been established. At the same time, the results of repeated surveys of medical workers indicate that it is non-steroidal anti-inflammatory drugs that are most often prescribed to this group of patients. It should be borne in mind that their long-term, often uncontrolled use is associated with a high risk of complications, including severe ones, the most common of which are lesions of the gastric mucosa with ulceration, increased blood pressure, and an increased risk of atherothrombotic complications [8,20 ].
    The results of a number of experimental works and clinical studies indicate that today the optimal approach to the treatment of such patients is the use of antidepressants and antiepileptic drugs. There is sufficient experience in the clinical use of antidepressants for the relief of pain in patients with neuropathic pain and chronic pain syndromes. For this purpose, tricyclic antidepressants are most widely used, and the maximum experience gained in the conditions of randomized clinical trials has been accumulated in relation to amitriptyline.
    Based on the results of a meta-analysis of 19 double-blind randomized clinical trials (a total of 2515 patients with neuropathic pain syndromes, excluding headaches and migraine), it was found that antidepressants are most effective against neuropathic pain syndromes caused by distal pain diabetic polyneuropathy and postherpetic neuralgia. This group of drugs was less effective against pain syndromes caused by HIV infection and some other clinical conditions [24]. The authors of the cited meta-analysis, like most other researchers, note that in order to achieve a therapeutic effect, the use of drugs in high doses is often required, which is associated with an increased risk of side effects. In particular, this complicates the widespread use of drugs on an outpatient basis, reduces the adherence of patients to treatment.
    For the treatment of patients with neuropathic pain, chronic pain syndromes, in addition to tricyclic antidepressants, drugs from the group of serotonin reuptake inhibitors are also used, which, in addition, when administered in therapeutic doses, have the ability to suppress the reuptake and noradrenaline – drugs “dual action”, representative which is venlafaxine (Velafax) [19].
    The results of experimental studies convincingly prove that venlafaxine has its own analgesic activity, which is not related to its antidepressant properties. Thus, the positive effect of venlafaxine, associated with the peculiarities of its chemical structure, is observed in patients with chronic pain syndromes associated with depressive disorders, and without them [7]. Interestingly, in some cases, the analgesic effect occurs when using doses of the drug that are smaller than those that cause the actual antidepressant effect. It is also believed that the analgesic effect in this situation is due to the interaction of the drug with both serotonin and norepinephrine receptors, and modulation of the synaptic uptake of mediators by dopamine can play a significant role. In addition, there is evidence that the analgesic effect of the drug to a certain extent can be explained by its interaction with opioid systems (primarily with

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