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Venlafaxine ( Effexor )


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#1 firelizardee

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Posted 05 March 2005 - 03:02 PM

:hearts:
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#2 Lindsay

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Posted 25 June 2004 - 03:07 AM

Venlafaxine ( Effexor ) a bicyclic antidepressant that inhibits the reuptake of serotonin, norepinphrine, and dopamine. This drug is used in the treatment of depression but is also used to treat OCD ( obsessive-compulsive disorder ) or Fibromyalgia ( FMS. )

CLASS:  Phenethylamine Monoamine Reuptake Inhibitor.
Generic name:  Venlafaxine Hydrochloride.
Type: Antidepressant.

Strengths:

Capsules:
25mg, 37.5mg, 50mg, 75mg, 100mg.

Dosages: Actual dosage must be determined by a physician.

Oral:
Start: 75mg in three 25mg doses daily.
Increases: In four day intervals, up to 225mg daily as needed.
Maximum: 225mg in 24 hours.

Normal dosage:

For Depression:
If under 18 years of age DO NOT USE!
18 to 60 years of age, 75mg daily in two or three dose with food.
Over 60 years of age, Lower dosage increased cautiously.

For OCD:
If under 18 years of age DO NOT USE!
18 to 60 years of age, 75mg daily in two or three dose with food. ( Larger dose may be needed )
Over 60 years of age, Lower dosage increased cautiously.

Problems with:

Liver Function:  Must lower dosage ( at less 50% ), as needed with careful monitoring.
Kidney Function:  Must lower dosage ( at less 25% ), as needed with careful monitoring.

Test:

Before taking:  Blood pressure.
While taking:  Blood pressure regularly.

Take With:  With food.

Full Benefits In:  In two weeks.

Missed Dose(s):  If within one hour take, if over an hour skip and then continue on your normal schedule.
Never Take a Double Dose!

If Stop Taking:  Do not stop without consulting your physician and never abruptly.

Overdose symptoms include:  Convulsions / seizure, fatigue, nausea, or vomiting.


--------------------------------------------------------------------------------

Warnings

The habit-forming potential is none.

Do not take this drug if you are pregnant, try some non-drug alternatives.

Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding.

Do not drink alcohol when taking this drug.

Do not give this drug to children under eighteen. If over sixty only use drug in small doses and with close monitoring of it's side effects.

Do not use if: You had negative reactions to this drug or any drug in this class in the past. If you have taken any MAO inhibitors in the last 14 days. If you have any type of seizures. ( Epilepsy or convulsions )

Inform your Doctor if: You had negative reactions to this drug or any drug in this class in the past. If you have taken any MAO inhibitors in the last 14 days. If you have a history of liver or kidney problems. If you have a history of seizures, hyperlipdemia, hypomania, or mania. If you are taking any other prescription or nonprescription drug.  If you plan to be under anesthesia or having any surgery in the next few months, also if you will be undergoing any medical tests.


--------------------------------------------------------------------------------

Venlafaxine ( Symptoms or Effects )

Common:  Anxiety, constipation, delayed orgasm, depression, difficulty breathing, dizziness, dry mouth, itching, loss of appetite, loss of strength, nausea, nervousness, problem urinating, sedation, skin rash, sleepiness / sleeplessness, sweating, tingling hands / feet, tremors, vomiting, unusual dreams, weight loss, or weakness.

Rare:  Abnormal speech, bleeding / irritated gums, chest pain, dry skin, ear pain, hair loss, excessive salivation, migraines, seizures, sensitivity to sun, soft stools, stomach irritation, suicide attempts, taste disorders, tongue discoloring, thyroid changes, or problems with vision.

See physician always:  Abnormal speech, bleeding / irritated gums, chest pain, depression, difficulty breathing, dry skin, ear pain, hair loss, excessive salivation, loss of strength, migraines, problem urinating, seizures, sensitivity to sun, soft stools, stomach irritation, suicide attempts, taste disorders, tongue discoloring, thyroid changes, tremors, problems with vision, or vomiting

See physician if severe:  Anxiety, constipation, delayed orgasm, dizziness, dry mouth, itching, loss of appetite, nausea, nervousness, sedation, sleepiness / sleeplessness, sweating, tingling hands / feet, unusual dreams, weight loss, or weakness.

See physician NOW:  Skin rash or vomiting.

Stop taking and see physician NOW:
DESCRIPTION
Effexor (venlafaxine hydrochloride) is a structurally novel antidepressant for oral administration.
It is chemically unrelated to tricyclic, tetracyclic, or other available antidepressant agents. It is
designated (R/S)-1-[2-(dimethylamino)-1-(4-methoxyphenyl)ethyl] cyclohexanol hydrochloride
or (¡¾)-1-[¥Ã¡-[(dimethyl-amino)methyl]-p-methoxybenzyl] cyclohexanol hydrochloride and has
the empirical formula of C17H27NO2 HCl. Its molecular weight is 313.87. The structural formula
is shown below.

Venlafaxine hydrochloride is a white to off-white crystalline solid with a solubility of
572 mg/mL in water (adjusted to ionic strength of 0.2 M with sodium chloride). Its octanol:
water (0.2 M sodium chloride) partition coefficient is 0.43.
Compressed tablets contain venlafaxine hydrochloride equivalent to 25 mg, 37.5 mg, 50 mg,
75 mg, or 100 mg venlafaxine. Inactive ingredients consist of cellulose, iron oxides, lactose,
magnesium stearate, and sodium starch glycolate.


CLINICAL PHARMACOLOGY

WARNINGS
Potential for Interaction with Monoamine Oxidase Inhibitors
Adverse reactions, some of which were serious, have been reported in patients who have
recently been discontinued from a monoamine oxidase inhibitor (MAOI) and started on
Effexor, or who have recently had Effexor therapy discontinued prior to initiation of an
MAOI. These reactions have included tremor, myoclonus, diaphoresis, nausea, vomiting,
flushing, dizziness, hyperthermia with features resembling neuroleptic malignant
syndrome, seizures, and death. In patients receiving antidepressants with pharmacological
properties similar to venlafaxine in combination with a monoamine oxidase inhibitor, there
have also been reports of serious, sometimes fatal, reactions. For a selective serotonin
reuptake inhibitor, these reactions have included hyperthermia, rigidity, myoclonus,
autonomic instability with possible rapid fluctuations of vital signs, and mental status
changes that include extreme agitation progressing to delirium and coma. Some cases
presented with features resembling neuroleptic malignant syndrome. Severe hyperthermia
and seizures, sometimes fatal, have been reported in association with the combined use of
tricyclic antidepressants and MAOIs. These reactions have also been reported in patients
who have recently discontinued these drugs and have been started on an MAOI. Therefore,
it is recommended that Effexor not be used in combination with an MAOI, or within at
least 14 days of discontinuing treatment with an MAOI. Based on the half-life of Effexor, at
least 7 days should be allowed after stopping Effexor before starting an MAOI.
Sustained Hypertension
Venlafaxine treatment is associated with sustained increases in blood pressure in some patients.

Be Well....

~Lindsay ღ , Forum Super Administrator
Founder, depressionforums.org


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"Lasting effect" is a self -contradictory term.  Meaning does not exist in the future, nor do I.  
Nothing will have meaning, "ultimately."
Nothing will even mean tomorrow what it did today.  Meaning changes with the context.  
My meaningfulness is in the here and now. It is enough that I may be of value to someone today.
It is enough that I make a difference now."  ~Lindsay    
    

  
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#3 firelizardee

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Posted 05 July 2004 - 12:44 PM

In the UK Efexor XL comes in 75mg and 150mg capsules.  The tablets come in 75mg and I think 150mg.
Take care
Firelizardee

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"Only Robinson Crusoe can get things done by Friday!"

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#4 firelizardee

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Posted 08 July 2004 - 02:14 PM

This topic was originally started on Nov. 13 2001.  

If you have a link about effexor that is not already here please send me a Private Message with the details.

Thanks.
Eileen

External sites with info on depression, effexor or other related subjects.

http://depression.about.com

British National Formula (BNF), similar to Physicians Desktop reference - useful for looking up any UK Drug.

Info on Effexor and under TIPS has links to lots of other sites.

Doctors' Answers to "Frequently Asked Questions" - Effexor

http://familydoctor.org/

if you want to know about neurotransmitters.


Side Effects

The most likely side effects at first are (NOTE you may get them all or only some of them):

Dry mouth
Nausea
Headache
Restless Sleep
Vivid Dreams
Lack of appetite
sweating (see post further down about a drug that might counteract the sweating).
constipation
agitation
confustion


What does the drug do, how does it work?

lists a lot of side effects of effexor.


Coming Off Effexor
Please talk to your Doctor before stopping ANY ANTI-DEPRESSANT.  Stopping ANY ANTI-DEPRESSANT suddenly can lead to discontinuation symptoms.

Article about discontinuing Antidepressants
Basically it says if problems comging off effexor, switch to prozac and wean off that.
medscape.com  you will have to register to read any article.

Some folk may get Brain Shivers / Electric Shocks / Brain Zaps when stopping Effexor.   May occur if Effexor is stopped suddenly.

Some pharmacists have suggested:
Benedryl liquid
Emetrol for the nausea


Drug Interactions
Many of us who take antidepressants also take other drugs.  Do you tell your pharmacist/dr about what other drugs/vitamins etc you take when you get your prescription filled?

Look at this site and click on the Pharmacy tab then select the Interactions from the list.  

Thanks to Bondgirl and SweetMelissa for bringing this to the forums attention.

http://www.drugstore...?catid=60&trx=0


Scientific Papers
http://www.biopsychi...milnacipran.htm
http://www.biopsychi...com/tricevo.htm
http://www.prous.com...83408/index.cfm
In french
http://www.biam2.org/www/Sub5133.html
http://www.biam2.org/www/Spe25675.html
Take care
Firelizardee

"Eat a live frog before breakfast and nothing worse will happen to you all day"
"Only Robinson Crusoe can get things done by Friday!"

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#5 firelizardee

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Posted 08 July 2004 - 02:16 PM

Posted by: charva on Jan. 11 2002,18:28

A very interesting discussion of antidepressants that don't fall into a general group:

< Description of Effexor and how it works >


"Bupropion (Wellbutrin), trazodone (Desyrel), venlafaxine (Effexor), and mirtazapine (Remeron) are a group of structurally unrelated antidepressants that don't fit into any of the established antidepressant drug classes of MAOIs, tricyclics, or SSRIs.

These three are among a group of drugs that scientists have discovered as a result of fiddling with the biochemistry of antidepressants, looking for the perfect medication that's safe, nontoxic, and effective. Although all three are very effective antidepressants, each one affects a different neurotransmitter system: Wellbutrin affects dopamine, Desyrel affects serotonin, and Effexor affects norepinephrine, serotonin, and dopamine, while Remeron stimulates norepinephrine and serotonin release as it blocks certain receptors.

Pros and Cons

Wellbutrin, Effexor, Desyrel, and Remeron appear to cause fewer serious side effects than MAO inhibitors or tricyclics. But because these three drugs can cause a few unusual problems in some people, chances are your psychiatrist will be far more likely to choose an SSRI like Prozac or Zoloft at first.

The most common side effects shared by Wellbutrin, Effexor, and Desyrel include agitation, dry mouth, insomnia, headache, nausea and vomiting, constipation, and tremors.

But perhaps the most troubling problem with the newer drugs is that no one is sure just what their long-term effects might be. There are some new, troubling reports that Effexor may cause tardive dyskinesia, a movement disorder that may be permanent, involving writhing, wormlike movements of the body, lips, and tongue.

But many chronically depressed people say they don't care. They're willing to pay the price of future uncertainty to buy freedom from depression today.

"There are risks to these drugs," says Joan, whose training as a nurse makes her more aware than most of the possible hazards. "They just don't know what they do in the body. But after this many years of being depressed, it's worth the risk to me. I've spent half my life in h**l, so taking a risk with antidepressants is well worth the effort. As more years have gone by, I see the years I was depressed as wasted. I don't want to waste any more."

Effexor

If you had your heart set on taking Prozac and were disappointed when nothing happened, there's a drug that seems to work especially well for the up to 40 percent who don't respond to serotonin-related antidepressants. It's called Effexor, approved in 1994 by the FDA. Because Effexor is structurally unlike SSRIs, people who don't respond to Prozac, Zoloft, or one of the tricyclics often do respond to this antidepressant. It's so new, however, that doctors don't know a lot about how this drug will act on a long-term basis. As mentioned above, there are some concerns that this drug may cause tardive dyskinesia -- usually after long-term use, although there have been some cases appearing after only one dose.

Tricia, 39, is a Boston nurse who ended up taking Effexor for a lifelong depression after trying every known tricyclic. "The first effects of Effexor were visual," she recalls. "I felt as if there was a cool breeze blowing behind my eyes. Colors were sharper, and all my senses perked up. I feel the way I imagine normal people feel, without struggling through the haze of depression. It clarified things."

The feeling of clarity was especially important to Tricia, who was terrified that the muted experience of her depression would lead her to make mistakes at work. "I was constantly afraid I would **** someone," she recalls. As a result, she became hypervigilant at work, putting so much energy into her job that at the end of the day she was totally exhausted.

"Before Effexor, every morning I would usually have a few suicidal thoughts before I left for work in the morning. Now I'm afraid that this (normal feeling) will be taken away."

Before Taking These Drugs

Just as with other antidepressants, you've got to be sure to tell your doctor if you've ever had allergies to any antidepressants, foods, preservatives, or dyes, and if you have suffered from manic depression, convulsions, or seizures. Be sure to report liver disease, since this condition may raise blood levels of any antidepressant, which can in-crease the risk of side effects. If you have any type of seizure disorder, recent head injury, brain or spinal-cord tumor, bulimia, or anorexia nervosa, you shouldn't take Wellbutrin either, since all of these problems have been associated with a higher risk for seizures. And if you've had a recent heart attack, you may not be able to take antidepressant medication.

Additional Tests

If you're taking Wellbutrin, talk to your doctor about the possible need for follow-up medical exams or studies to check kidney and liver function or blood levels of the drug.

When taking Desyrel, you may need to take complete blood-cell-count tests, since this drug can reduce your white-blood-cell count. (White blood cells are an important part of your body's immune system, and low levels could be a problem if you develop an infection, sore throat, or fever.) Because of the link between Desyrel and some heart problems, your doctor may ask you to have blood-pressure readings and electrocardiograms.

How to Take These Drugs

To lessen stomach upset, it's a good idea to take any of these three drugs with meals unless your doctor has specifically asked you to take your medication on an empty stomach.

When taking Wellbutrin, you should equally divide your medication into three or four doses a day to minimize the risk of seizure. Never drink alcohol while taking Wellbutrin, since this also may increase the risk of seizure.

If you get too sleepy or dizzy with Desyrel, ask your doctor if you can take a larger portion of your total daily dose at bedtime, dividing the rest into two or three smaller doses during the day.

Possible Drug Interactions

As with all antidepressants, you should talk to your doctor before taking any other drugs (even nonprescription medications).

Taking Wellbutrin with a tricyclic antidepressant may increase the risk of seizure. Taking Wellbutrin with an MAO inhibitor, or within two weeks of taking an MAO inhibitor, will increase the chance of side effects. At least two weeks should pass between stopping one medication and taking another.

Overdose

An overdose is less of a problem with the newer antidepressants. That's another reason why doctors like to give these newer drugs to suicidal patients -- they're less likely to be able to take a fatal overdose. If you overdose on Wellbutrin, you'll probably recover, although you might experience seizures or hallucinations or lose consciousness. Still, there have been cases of heart failure and fatalities from Wellbutrin overdoses.

Pregnancy and Breast-Feeding

If you want to get pregnant while you're on an antidepressant, you're going to have to weigh the risks to your baby against the risks to you if you don't take the drug. As with most antidepressants, what we know about their activity in pregnant women is mostly obtained from animal studies, not from large-scale studies in humans.

Your best choice might be Wellbutrin, which hasn't caused birth defects or other development problems in animal studies even in doses up to 45 times the human daily dose. The effect of Wellbutrin on labor and delivery in humans isn't known, however.

Desyrel seems a little more risky; animal studies with this drug have revealed fetal deaths and birth defects. As a result, use of Desyrel is not recommended during the first three months of pregnancy.

You and your doctor should weigh the potential risks to the fetus and to you before you decide whether or not to take antidepressants during pregnancy.

There's always a potential for adverse reactions in nursing infants (especially with Wellbutrin). If you're a new mom, you need to weigh the risks to you of not taking medication against the potential harm to your baby.

Use with the Elderly

If you're over age 60, you're more likely to be sensitive to all of the antidepressants. This means your depression will probably respond to lower doses of medication. It also means you are at higher risk for developing side effects.

Some antidepressants may be a better choice than others, of course. For example, studies with Wellbutrin in a limited number of patients over age 60 haven't found any problems caused by the drug."



< http://www.ncbi.nlm....in-p....&Dopt=b >

Ann Pharmacother 2002 Jan;36(1):67-71

Serotonin syndrome caused by selective serotonin reuptake-inhibitors-metoclopramide interaction.

Fisher AA, Davis MW
Canberra Hospital, PO Box 11, Woden ACT 2606, Australia.

[Medline record in process]


OBJECTIVE: To report 2 cases of serotonin syndrome with serious extrapyramidal movement disorders occurring when metoclopramide was coadministered with sertraline or venlafaxine. CASE SUMMARY: A 72-year-old white woman was treated with sertraline for depression for 18 months and was then admitted to the hospital with a fractured tibia. She was administered metoclopramide because of nausea and, within 2 hours, developed agitation, dysarthria, diaphoresis, and a movement disorder. These symptoms recurred following 2 subsequent administrations of metoclopramide. Treatment with diazepam led to resolution of symptoms within 6 hours, and there was no recurrence at 6 weeks' follow-up. A 32-year-old white woman with major depression was treated with venlafaxine for 3 years. She was admitted following a fall and, after being given metoclopramide, developed movement disorder and a period of unresponsiveness. After a second dose of metoclopramide, these symptoms recurred and were associated with confusion, agitation, fever, diaphoresis, tachypnea, tachycardia, and hypertension. She improved with administration of diazepam, but needed repetition of this treatment over the next 16 hours. Symptoms resolved within 2 days, and she continued venlafaxine with no further adverse effects. DISCUSSION: Both cases met Stembach's criteria for serotonin syndrome and had serious extrapyramidal movement disorders. The possible pathophysiologic mechanisms for the adverse reactions include a single-drug effect, a pharmacodynamic interaction, and a pharmacokinetic interaction. We believe that a pharmacodynamic interaction is most likely. CONCLUSIONS: Clinicians should be aware of a risk of serotonin syndrome with serious extrapyramidal reactions in patients receiving sertraline or venlafaxine when metoclopramide is coadministered even in a single, conventional dose.

PMID: 11816261, UI: 21675736
Take care
Firelizardee

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"Only Robinson Crusoe can get things done by Friday!"

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#6 firelizardee

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Posted 08 July 2004 - 02:17 PM

SWEATING

+---Topic: Slippie Slidey Super Sweaty Sister started by peahen
--------------------------------------------------------------------------------


Posted by: peahen on Oct. 03 2002,17:29

I know that sweating is listed as a side effect of Effexor. However - the combination of Effexor XR, Menopause and living in Florida has me in a constant state of feeling like someone just dumped a bucket of water over me.  

My doctor has recommended Cogentin (Benztropine Mesylate) as a 'drying' agent. It is normally used as a Parkinson's drug, but was found to help with excessive sweating.

I'd like to know if anyone has tried this, or anything else for relief  

Thanks, all!
  • mmdrodrigues likes this
Take care
Firelizardee

"Eat a live frog before breakfast and nothing worse will happen to you all day"
"Only Robinson Crusoe can get things done by Friday!"

Posted ImagePosted Image


Suicide help on DF

UK help for people who are suicidal

I am not a medical professional, when I reply to posts I do so basing my reply on personal experience or a wish to support the poster.




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