Highlighting uses, dosage, reviews, how to take & discontinue, side effects, pros & cons, and more
Brand & Generic Names; Drug Classes
|US brand name: Effexor|
|Generic name: venlafaxine|
|Primary drug class: Antidepressants|
|Additional drug class(es): Serotonin and Norepinephrine Reuptake Inhibitor (SNRI)|
Approved & Off-Label Uses (Indications)
Effexor’s US FDA Approved Treatment(s)
Uses Approved Overseas but not in the US
Off-Label Uses of Effexor
- Bipolar depression
- Depression in Parkinson’s Disorder
- Hot flashes due to breast cancer therapy (thanks to Betsy!)
- Migraine prevention (prophylaxis)
- Tension-Type Headaches
- Although in this randomized, double-blind trial Effexor didn’t do shit for the pain of fibromyalgia. It was still effective for other fibro symptoms.
- As venlafaxine is an SNRI it’s popular (in Europe at least) as a treatment for chronic nerve pain from conditions such as:
- shingles (post herpetic neuralgia)
- diabetic peripheral neuropathy
- phantom limb syndrome
- Chronic Fatigue , along with every other drug on the planet.
- Adult ADD/ADHD
- Irritable Bowel Syndrome (IBS)
- Eating Disorders:
When & If Effexor Will Work
Effexor’s Usual Onset of Action (when it starts working)
Three weeks to a month.
Likelihood of Working
Generally SNRIs are more likely to work than SSRIs for depression and some forms of anxiety. Their biggest advantage being they are far less likely to suddenly stop working (see the SSRI poop-out (tachyphylaxis) page for details). The problem with Effexor is that the reviews from the field don’t form a bell curve or long tail like most stats, but a U, with most people loving it or hating it, as a lot of its efficacy was overshadowed by how bad it was to stop taking it. Fortunately that isn’t as much of a problem today as it was the first 10 years Effexor was on the market. Wyeth finally owned up to the fact that discontinuation syndrome exists and it can be really fucking awful. Doctors realized the same thing. Score another one for Internet-based support groups and sites like Crazymeds, as it sure as hell wasn’t getting published in The Literature all that much before we started making a lot of noise about it.
So, like all SNRIs, Effexor does work. Due to its side effects and the chance of the discontinuation syndrome from hell I can’t suggest it as the first med to try, unless you’re reading this for someone who is too depressed to work up the energy to kill themself - in which case that person should be hospitalized so they don’t do just that when the Effexor or whatever kicks in - or too anxious to look at a computer. If you aren’t quite that bad and your doctor brings it up, ask about something else for the first go. Not Pristiq, which is just predigested Effexor, albeit with a slightly different way of working, but either an SSRI or even Cymbalta. If you want something to work right the fuck now, Lexapro is your best bet.
Let’s see what Science has to say about it…
Effexor for Depression
- Effexor XR for Depressed Slovenes When Laibach isn’t enough. This smallish (161 participants to start, 148 completed. 75% female.) study is notable not only for being the first to evaluate Effexor XR for MDD in Slovenia, but for using more than just the HAM-D to evaluate the results. Not only did Dr. Plesničar use four different rating scales, she also evaluated patients for physical pain, a symptom of depression frequently ignored. The results: Effexor kicked depression’s ass and didn’t suck all that much. As the study lasted only 8 weeks it didn’t have much of a chance to deal with weight gain or discontinuation syndrome. The 3:1 ratio of women to men also downplayed any sexual side effects. Still, I wish she had more money for a larger and longer study.
- Effexor XR for Depressed Women Aged 45-55. The idea of this study was to see if there’s a difference in effect for women before and after menopause. While they tracked the women for a decent amount of time, they used only the HAM-D and there were only 36 participants, so the data are interesting but not all that conclusive. The results: Effexor works better and sucks less for post-menopausal women.
Effexor vs. Other Antidepressants for Depression
- Effexor vs. Prozac vs. Placebo. Which is the most likely to fail after two years? After just one year 73% of the people taking the placebo were severely depressed again. So much for the placebo effect making ADs overpriced, side effects-inducing placebos. Effexor pooped out for 61% of the people taking it, but as this was a double-blind study, the dosages were completely randomized. A participant could have been taking 75 mg a day for a year. Or 300 mg. Or somewhere in between. Prozac randomization was 20–60 mg and the tachyphylaxis rate was 66%. Phase B was even more messed up. This study is pretty bogus. The only thing about it worthwhile is that it shows the placebo effect is equally bogus. Medicine works.
I <3 Effexor
I Loathe Effexor
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Taking and Discontinuing
How to Take Effexor
Effexor comes in immediate-release (IR) and extended release (XR) flavors, although hardly anyone takes the IR form anymore. Just be sure to check your prescription for that XR to make sure you are getting the extended release form. For the XR flavor, you start at 37.5 to 75mg a day, taken with food, at either breakfast or dinner, depending on if you’re apt to get wired or tired. Once you get the wired/tired issue straightened out, you take the med all at once at the same time every day. If you start at 37.5mg you can move up to 75mg after a week. As with any serotonergic antidepressant, it may take up to a month to feel any positive effect, so give it a month. Seriously, don’t move up above 75mg a day unless you feel it doing something positive or it’s been about a month. You’ll know if it’s going to do anything then. If you feel nothing, give up and take a med with a much easier discontinuation (i.e. anything that’s not an SNRI). After that you can move up in 37.5–75 mg increments, allowing at least a week between each increase until you reach the maximum of 375mg a day for the most severely depressed of patients. Or 450mg a day if you and your doctor have the balls for it. If the two of you are sure you are a rapid metabolizer of some medications, there are people who take 600mg a day, but roughly 1% of people on the planet, if that many, would metabolize it at a rate fast enough to need 600mg a day, and need to take the XR form twice a day. If you’re reading this site because you take your XR capsule in the morning and feel dizzy, confused, have headaches and feel like you’re wearing an electric eel for a hat after dinner every night, you may need to take a once-a-day pill twice a day.
The older immediate release version is pretty much the same, except that the dose is divided into two or three doses a day.
In some ways Effexor is almost like an AED in that you need to fine-tune its dosage for maximum effect.
How to Stop Taking Effexor (discontinuation / withdrawal)
Unless you need to discontinue the XR flavor at a more rapid rate due to an extremely nasty side effect, your doctor should be recommending that you reduce your dosage by 37.5mg a day every week if you need to stop taking it, if not more slowly than that. You shouldn’t be doing it any faster than that unless it’s an emergency. Yes, that means if you’ve maxed out at 375mg a day it could take up to 10 weeks to get off of it. You can try it faster and hope it works out, and since the odds are actually with you it’s worth doing at the higher dosages and reduce the rate once you’re down to half of what you used to take, but it’s hardly a sure thing. Once you get down to that last 37.5mg a day you have several options:
- If the discontinuation symptoms you’re experiencing are mild, if you’re experiencing any at all, then you may as well stop taking it. You’re in the plurality of people who have taken either version of Effexor who could stop taking it without too much of a hassle.
- If the brain zaps or shivers and other discontinuation symptoms are still bad you can try taking one 37.5mg capsule every other day, or getting a prescription for generic venlafaxine IR and working your way down. As IR comes in a variety of dosages you have all sorts of ways you and your doctor can work out a discontinuation schedule from there.
- If you still can’t stop taking it at a low dosage, you and your doctor may want to try Prozac (fluoxetine) prescription or samples. Generic fluoxetine will even do. 10mg a day is all you should need. Even with the proper discontinuation stopping the last 37.5mg can be hellish. Taking two weeks worth of Prozac (fluoxetine) will make the discontinuation a lot easier. So when you’re off of it and you cannot function, get on the Prozac for a week or two, then stop taking the Prozac. By that time you should find you’ll have either no discontinuation syndrome, or it won’t be nearly as bad.
- If worse comes to worst, there’s always the liquid Prozac. Then you can work your way down from the equivalent of 10mg, or higher if 10mg was too low, to ever-so-slowly try to wean yourself off of the serotonergic part of Effexor that had its claws in you. Unlike most liquid medications of any type, Prozac’s oral solution tastes pretty good3, somewhere between really good mint-flavored mouthwash and so-so peppermint schnapps.
Medicine Is The Best Medicine
I <3 Wellbutrin
Effexor’s Pros and Cons
- For deep, despairing, clinical depression that will only respond to the standard tweaking of at least two out of the three most popular neurotransmitters4, Effexor often pulls people out of the abyss when SSIs, other SNRIs, Wellbutrin, and TCAs have failed.
- Because Effexor works on more than one neurotransmitter, it is far less likely to poop-out than an SSRI.
- For many people Effexor has the absolute worst discontinuation syndrome of any antidepressant.
- It is a medication people utterly loathe to have taken.
- It is not uncommon for someone to fire their doctor during or immediately after they quit taking Effexor because the discontinuation syndrome can be that bad.
Interesting Stuff your Doctor Probably didn’t Tell You about Effexor
Raw, freebase5 venlafaxine is actually one of, if not the least potent of all the antidepressants on the market.
If venlafaxine hydrochloride weren’t so well absorbed and distributed Let’s see if I can write it down correctly this time. If the active ingredient were as well-absorbed and distributed when compared with the other ADs I could understand why it is so effective. As it is, I can’t understand why the hell it isn’t be practically a placebo. Those awesome shitty pharmacokinetics may have something to do with why the discontinuation syndrome sucks so much donkey dong, but that’s still just a guess of mine and there’s no research to back it up. Just like Paxil, the short half-lives of venlafaxine HCl and its active metabolite are a known reason why Effexor withdrawal sucks so much shit. And why some people experience SSRI/SNRI discontinuation syndrome if they miss a single dose, or are a few hours late in taking a dose!
It could be that it’s like bupropion, another weak-as-water6 drug that is surprisingly effective. According to Dr. Stahl, bupropion might be transformed into one or more of its three (so far known) active metabolites by the CYP450 genes in your brain instead of in your liver. So what it doesn’t have in the way of raw, pharmacological power, it makes up for by being undiluted by plasma. Perhaps venlafaxine HCl does the same thing.
Best Known for
The discontinuation syndrome from hell.
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Effexor’s Side Effects
Side Effects All crazy meds Have
No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.
- Drowsiness / fatigue - even when taking stimulants in some circumstances.
- Insomnia , instead of or alternating with the drowsiness.
- Assorted other minor GI complaints (constipation, diarrhea, etc.)
- Generally feeling spacey / out of it
- All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
- Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.
Typical Side Effects
Although an SNRI, because its effect on norepinephrine usually isn’t noticeable until you reach a dosage somewhere north of 150mg a day, its initial, and mostly short-term, side effects are more like an SSRI. Not that there’s all that much difference between the two classes. So expect a few of:headache, nausea, dry mouth, sweating, sleepiness or insomnia (with insomnia a little more likely), constipation or diarrhea (constipation is somewhat more likely), weight gain (although less likely and severe than most SSRIs), and assorted sexual dysfunctions. While sexual dysfunction is also a little less likely than SSRIs, some women will get a sexual boost at the higher dosages instead of a sexual dampening. It’s neither as frequent nor as pronounced (usually) as with the other SNRIs or the NSRIs (Strattera and reboxetine), but it does happen.
Sorry guys, but a higher dosage usually means whatever problems you had in that area will probably just get worse.
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Uncommon Side Effects
- increased or lowered blood pressure
- shock-like sensations (while you’re still taking it)
- alcohol intolerance and/or alcohol abuse
- making it just the thing to talk about at AA meetings
- making it just the thing to talk about at AA meetings
Freaky Rare Side Effects
- Guys, if you thought everyone freaking out about the Lamictal Rash was bad, I have one word for you: balanitis.
- Your hair may change color without Revlon.
- You know, I think that new hair color looks good on you…
- Spontaneous orgasm.
- OK, fine, take care of yourself then.
- OK, fine, take care of yourself then.
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What You Really Need to be Careful About
C-Use with caution
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Effexor’s Half-Life & How Long Until It Clears Your System
Plasma half-life: The half-life of venlafaxine is 3–7 hours, and o-desmethylvenlafaxine’s is 9–13 hours. That means it takes two days for one and five days for the other to clear out of your system.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream8, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what9, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.
Steady state is reached in: three days
Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.
How venlafaxine Works
the current best guess at any rate
The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.
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Effexor’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions
Medicine Is The Best Medicine stickers
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Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.
Name, Address, Serial Number (Generic and Overseas Availability)
Available in the US as a generic? Yes
Other Trade Names and Overseas Availability
Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).
Available as Effexor in
- Algeria (إفإكسور in Arabic)
Overseas Trade and Branded Generic Names
- Algeria / الجزائر - Flaxyne / فلاكسين , Venexor / فينيكسور
- Argentina - Alfaxin , Efexor , Elafax , Ganafax , Mezine , Pramina , Quilarex , Sesaren , Sunvex , Venlifax
- Armenia / Հայաստան - Efevelon / Էֆեվելոն
- Australia - Altven , Efexor, Elaxine , Enlafax
- Austria / Österreich - Efectin , Faxiprol , Venaxabene , Venlafab
- Bahrain - Efexor
- Belarus / Беларусь - Alventa / Алвента , Deprexor / Депрексор , Efevelon, Velaxin / Велаксин
- Belgium / België / Belgique - Efexor, Venlax
- Bolivia - Elafax, Nervix , Oprax , Sesaren, Venlax
- Bosnia & Herzegovina / Bosna i Hercegovina - Alventa, Depressa , Efexiva 10, Velafax , Venlax, Zanfexa
- Brazil - Alenthus ,Efexor, Venlaxin , Venlaxina , Venlift
- Bulgaria / България - Alventa / Алвента, Argofan / Аргофан , Deprexor / Депрексор, Efectin / Ефектин , Efevelon / Эфевелон , Efexiva / Ефексива , Elify / Елифай , Estaq / Естак , Lanvexin / Ланвексин , Laroxin / Лароксин , Nopekar / Нопекар , Prefaxin / Префаксин , Tifaxin / Тифаксин , Velaxin / Велаксин, Venlagamma / Венлагамма , Venlift / Венлифт ,
- Chile - Axone , Depurol , Ectien , Efexor, Elafax, Lafaxin , Nervix, Nezel , Norpilen , Senexon , Sentidol , Sesaren, Subelan , Vencontrol , Venlax
- China / 中国 - Efexor / 怡諾思
- Colombia - Desmaril , Eduxon , Efexor, Exer , Hanxinex , Leire , Mezine, Niztec , Norpilen, Procaps , Sesaren, Vencontrol, Vendep , Veniz , Venlax, Venoxor , Vilfax
- Costa Rica - Efexor, Neurosenexon , Sesaren
- Croatia / Hrvatska - Alventa, Efexiva, Velafax, Velfax , Vexin , Zanfexa
- Cyprus - Efexor
- Czech Republic / Česká republika - Argofan, Efectin, Elify, Faxiprol, Mollome , Olwexya , Tifaxin, Velaxin
- Denmark - Dobupal , Efexor, Vandral
- Dominican Republic / República Dominicana - Efexor, Elafax, Lafaxin, Valax , Venfane
- Ecuador - Ansifix , Efexor, Valax, Sesaren, Venlax
- Egypt / مصر - Delvena , Efexor / إفإكسور , Effegad , Effoxbelle , Idixor , Venlatrin , Venlaxine , Vexamod
- El Salvador - Efexor
- Estonia / Eesti - Alventa, Argofan, Efexor, Faxiv , Lanvexin, Sulinex , Venegis , Venib , Venladep , Venlagamma, Vessril
- Finland / Suomi - Akaven , Alventa, Efexor, Faxoven , Ofaven , Velassine , Venlafarm , Venlar , Venlasan , Vexipress
- France - Trevilor
- Georgia / საქართველო - Velaxin, Venlagamma, Venlaxor
- Germany / Deutschland - Lindalex , Trevilor, Venla ,Venlagamma, Venla-q Venlasan
- Greece / Ελλάδα - Argofan, Arvifax , Deprevix , Efaxin , Efetrin , Efexor, Elify, Melocin , Memomax , Norafexine , Norezor , Serosmine , Tudor , Velept , Velpine , Venaxol , Ven-Fax , Venfaxil , Venlasan, Venlaxin, Voxafen , Zacalen , Zaredrop
- Guatemala - Bonilux , Efexor, Limbic , Mezine, Neurosenexon, Sesaren, Sinasfix , Venlacross , Veslodat
- Honduras - Efexor
- Hong Kong / 香港 - Efexor / 怡諾思
- Hungary / Magyarország - Efectin, Falven , Faxiprol, Jarvis , Olwexya, Venlagamma, Venlaxin
- Iceland - Efexor
- India / भारत - Dalium , Envelaf , Flavix , Sentosa , Velaf , Velfex , Velax , Ven OD , Venaxin , Venish , Venlamax , Venlor , Venset , Ventab , Vendep, Veniz, Venjoy , Venla, Venlift, Venx , Vexor , VNF
- Indonesia - Efexor
- Iran / ایران - Alventa, Depraxin , Deprilax , Venlabiox , Venlaxin
- Ireland / Éire - Efaxil , Efexor, Tonpular , Vedixal , Velexor , Venex , Venlablue , Venlift, Venlofex
- Israel / ישראל - Efexor / אפקסור, ViePax
- Italy - Efexor, Faxine , Tifaxin, Zaredrop, Zarelis
- Jordan / الأردن - Vaxor , Venexor / فينيكسور
- Kazakhstan / Казахстан - Alventa / Алвента, Efevelon / Эфевелон, Prefaxin / Префаксин, Velaxin / Велаксин
- Kenya - Veniz
- Latvia - Alventa, Argofan, Efexor, Elify, Prefaxine , Velaxin, Venlaxor
- Lebanon / لبنان - Defaxine / ديفاكسين , Efexor / إفإكسور , Venlax / فينلاكس
- Lithuania / Lietuva - Alventa, Efexor, Elify, Lanvexin, Velaxin
- Macedonia (FYROM) /македонија - Alventa / Алвента, Efexiva / Ефектин, Velafax, Velahibin , Venlax, Zanfexa
- Malaysia - Efexor
- Malta - Efexor
- Mexico - Adefaxin , Benolaxe , Efexor, Lafaxven , Mazda 11, Odven , Vextor
- Myanmar (Burma) - Venlift
- Netherlands - Efexor, Venfalex , Venladoz , Venlatif , Venlexor
- New Zealand - Efexor
- Nicaragua - Efexor
- Norway / Norge - Efexor
- Oman / عمان - Efexor / إفإكسور ,
- Pakistan / پاکستان - Amfax , Efexor, Enpress , Intefred , Peofax , Vanaxin , Vela , Venalax 12, Venice , Venxor , Vinoxa
- Panama - Efexor
- Paraguay - Elafax, Neoxacina , Sesaren,
- Peru - Anapresin , Asegur , Depurol , Efexor, Elafax, Noviser , Senexon, Vafexin , Veniz, Vfax
- Philippines - Efexor
- Poland / Polska - Alventa, Axyven , Efectin, Efevelon, Efexiva, Faxigen , Faxolet , Jarvis, Lafactin , Lanvexin, Nopekar, Oriven , Prefaxine, Symfaxin , Tavex , Tifaxin, Tonpular, Velfax, Velaxin, Velaxiran 13, VenaLEK , Venlabax , Venlagamma, Venlax, Venlectine , Zaredrop
- Portugal - Bitural , Desinax , Efexor, Efique , Genexin , Leritex , Pracet , Venxin , Xapnev , Zaredrop, Zarelix
- Romania - Adoxa , Alventa, Argofan, Efectin, Elify, Fobiless , Ivryx , Jarvis, Nopekar, Posipres , Velaxin, Venlagamma
- Russia / Россия - Alventa / Алвента, Efevelon / Эфевелон, Prefaxin / Префаксин, Velaxin / Велаксин
- Saudi Arabia / العربية السعودية - Efexor / إفإكسور , Venaxine , Venex , Vexal
- Serbia / Србија - Velafax
- Singapore / 新加坡 - Efexor, ViePax
- Slovakia / Slovensko - Alventa,
- Slovenia - Alventa, Efectin, Efexiva, Faxiprol, Nefexyl , Venlagamma
- South Korea / 남쪽 한국 - Cofexor / 코팩사 , Depron / 데프론 , Efexor / 이팩사 , Ivencine 14 / 이벤신 , Lavensa 15 / 라벤사 , Prexa / 프렉사 , Venexor / 베넥사 , Venfaxin / 벤팍신오알 , Venlafact / 벤라팩트 , Vivafaxine / 비바팍신 , 베라칸
- Spain / España - Arafaxina , Conervin , Dislaven , Dobupal, Flaxen 16, Levest , Vandral, Venlabrain , Venlamylan , Venlapine , Zaredrop, Zarelis
- Sweden / Sverige - Durnit , Efexor, Trevilor, Venette , Venlanidda , Venlix
- Switzerland / Suisse / Schweiz / Svizzera - Efexor, Venlax
- Taiwan / 台灣 - Calmdown 17, Easyfor , Efexor / 怡諾思, Faxine, Rafax , Seroxine , Valosine , Venfaxime , Venforspine
- Tanzania - Venexor, Venlift
- Thailand / ประเทศไทย - Efexor
- Turkey / Türkiye - Efexor, Sulinex, Venegis, Venfecto , Vessril
- UAE / الإمارات العربية المتحدة - Efexor /إفإكسور , Venlax / فينلاكس
- UK - Depefex , Efexor, Foraven , Politid , Sunveniz , Tonpular, Venaxx , Venladex , Venlalic , ViePax, Winfex
- Uganda - Venexor, Venlift
- Ukraine / Україна - Alventa / Алвента, Deprexor / Депрексор, Efevelon / Эфевелон, Faxine, Prefaxin / Префаксин, Velaxin / Велаксин,
- Uruguay - Elafax, Limbic, Nulev , Venxine
- Venezuela - Efexor, Idoxen , Lafaxim , Sesaren, Velmed
- Việt Nam - Venlift
because you can’t eat just one
- venlafaksin - Bosnian, Croatian, Norwegian, Serbian, Slovenian, Turkish
- venlafaksiin - Estonian
- venlafaksiini - Finnish
- venlafaxin - German, Swedish, Vietnamese
- venlafaxina - Italian, Portuguese, Spanish
- venlafaxinum 18 - Latin
- venlafaksino - Lithuanian
- venlafaxină - Romanian
- الفينلافاكسين Arabic transliteration of venlafaxine
- 文拉法辛 Chinese transliteration of venlafaxine
- венлафаксин Cyrillic transliteration of venlafaxine
- Βενλαφαξίνη Greek transliteration of Venlafaxine
- ונלפאקסין Hebrew transliteration of venlafaxine
- 벤라팍신 Korean transliteration of venlafaxine
Shapes & Sizes (How Supplied)
Extended-release capsules; Immediate-release, shield-shaped tablets
From left: Effexor XR 37.5 mg, Effexor 75 mg, Effexor 25 mg
Comments, PI Sheet, Ratings, Reviews and More
CommentsThere are two last resorts among the modern, first-line meds to cure the deepest, blackest depression when your doctor is just switching you from one horsie to another on the med-go-round: Effexor and Remeron (mirtazapine)19. Either in combination with an antipsychotic, especially Geodon would really get you out of that hole of despair, but first you should throw away every mirror and scale in your house and buy expandable clothing. Weight gain usually isn’t too bad with Effexor alone, but when coupled with Remeron and/or most antipsychotics…well…prepare yourself for being a jolly fatty.
Effexor has to be the. most. loathed. drug by those for whom it didn’t work. While it can be an absolute lifesaver for many people with the most severe form of whaleshit-on-the-bottom-of-the-ocean depression, with or without anxiety, as well as for those with various forms of anxiety without depression, when it doesn’t work well enough, and the side effects suck to much, the discontinuation syndrome can be such a nightmare that people will fire their doctors who didn’t work out a discontinuation schedule or otherwise prepare them for what it would be like.
A couple things I’ve picked up from the plethora of overseas SPCs and PILs I’ve collected (see below)
- In Australia they’ve noticed “an increased risk of bone fractures in patients receiving serotonin reuptake inhibitors (SRIs) including venlafaxine.”
- There’s nothing explicit about that in the US PI sheet, just a mention of osteoporosis as a rare side effect.
- Effexor is effective in treating depression in Parkinson’s Disorder, and that’s a very popular off-label use in east Asia.
- I can’t think of anyone more susceptible to bone fractures than old Asian women with Parkinson’s. Except for someone with osteogenesis imperfecta.
- I have no idea if the bone fracturing susceptibility from SSRIs and SNRIs is something that happens only to Australians, but it definitely happens with older adults no matter where they live, so if Grandma is taking Effexor or any other serotonergic drug, she needs to be even more careful about falling down and not being able to get up.
A bit more on its pharmacology for the pharmageeks:
The active metabolite (o-desmethylvenlafaxine) does most of the work, and is now available in a refined form as Pristiq (desvenlafaxine). The half-life of venlafaxine HCl is 3–7 hours, and o-desmethylvenlafaxine’s is 9–13 hours. That means it takes two days for one and five days for the other to clear out of your system. Having two parts with short half-lives is a huge part of why the discontinuation syndrome is so freaking harsh.
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Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, and Other Sites that may be of Interest
Prescribing Information and Patient Information from Around the World
PI = Prescribing Information PIL = Patient Information Leaflet PM = Product Monograph SPC = Summary of Product Characteristics CMI = Consumer Medicine/Medical Information MDS = Medicine Data Sheet EPAR = European Public Assessment Reports
See the page on how to read our drug guides for detailed translations and explanations of these and other prescribing information-related initialisms & acronyms.
- فينلافاكسين معلومات الدواء Arabic venlafaxine drug information.
- Argentina Elafax Prospectus
- հայերեն Էֆեվելոն SPC ռուսերեն - Armenian Efevelon (SPC) in Russian.
- Australian Altven Product Information (PI)
- Australian Efexor PI
- Australian Efexor XR CMI
- Brasileiro Efexor Informações ao Paciente Brazilian Efexor (PIL)
- Български Алвента Лекарствен справочник Bulgarian Alventa Patient Medical Guide
- Canadian Effexor XR PM
- Chileno Efexor Información Farmacológica
- 中国 怡諾思 简明处方资料 Chinese Efexor Consice Prescribing Information
- Hrvatski Alventa Sažetak Opisa Svojstava Lijeka Croatian Alventa SPC
- Hrvatski Velafax Uputa o Lijeku Croatian Velafax PIL
- Čeština Efectin Příbalová Informace: Informace pro Uživatele Czech Efectin PIL
- Dansk Venlafaxin Indlægsseddel: Information til brugeren Danish Venlafaxin PL: PIL
- Nederlands Efexor patiëntenbijsluiter Dutch Efexor PIL. And a hell of a lot more than patient information about Efexor.
- Nederlands Efexor Samenvatting van de Productkenmerken Dutch Efexor SPC
- Eesti Efexor Kullanma Talimatları Estonian Efexor PIL
- Eesti Efexor Ravimi Omaduste Kokkuvõte Estonian Efexor SPC
- Suomi Efexor PIL Finnish Efexor PIL
- Français venlafaxine Résumés des Caractéristiques du Produit French venlafaxine SPC
- Deutsch (German) Venlafaxin PIL
- Ελληνικά Efexor Φύλλο Οδηγιών για τον Χρήστη Greek Efexor PL
- Magyar Venlagamma Betegtájékoztató Hungarian Venlagamma PIL
- ایرانی venlafaxine اطلاعات دارویی Iranian venlafaxine drug information
- Irish Efexor XL SPC
- Irish Efexor XL PIL
- מידע סמים ישראלי אפקסור Israeli Efexor drug information
- Italiano Efexor Riassunto delle Caratteristiche del Prodotto Italian Efexor SPC
- казахский Алвента Инструкция по медицинскому применению лекарственного средства Kazakh Alventa Prescribing Instructions (PI) in Russian
- Kiwi Efexor XR Medicine Data Sheet New Zealand Efexor SPC
- 이팩사 한국의 제품설명서의 Korean Efexor Product Manual (SPC)
- Lebanese Venlax Package Insert / اللبنانيون فينلاكس حزمة إدراج. - in English and Arabic. For patients.
- Lietuvos Efexor Informacinis Lapelis Lithuanian Efexor Package Insert (PI). As with the Lebanese PI, this document is for patients.
- македонски Алвента Збирен Извештај за Особините на Лекот Macedonian Alventa SPC
- Malti Sommarju Globali tal-Evalwazzjoni Xjentifika ta’ Efexor Maltese Efexor SPC
- Mexicano Efexor Información Farmacológica SPC
- Paraguayo Neoxacina Información Farmacológica
- Peruano Efexor Información Farmacológica Peruvian Efexor SPC
- Polski Alventa Charakterystyki Produktów Leczniczych Polish Alventa SPC
- Português Efexor Folheto Informativo PIL
- Român Efectin Rezumatul Caracteristicilor Produsului Romanian Efectin SPC
- Pусский Эфевелон Инструкция по Применению Russian Efevelon Instructions for Use (SPC)
- Cрпски Velafax Uputstvo za Pacijenta Serbian Velafax Instructions for Patients (PIL)
- Cрпски Velafax Sažetak Karakteristika Leka Serbian Velafax SPC
- Slovenský Venlafaxin Písomná Informácia pre Používateľa Slovakian Venlafaxin PIL
- Slovenski Alventa Navodilo za Uporabo Slovenian Alventa User Instructions. It has both SPC and Package Leaflet on there. It looks like an EMA PIL.
- Español Flaxen Prospecto: Información para el Usuario Spanish Flaxen PIL
- Svizzera Venlax Informazione Destinata ai Pazienti - Swiss Venlax PIL in Italian.
- 台灣 venlafaxine 藥品信息 Taiwanese venlafaxine drug information
- ข้อมูลยาเสพติดไทย Efexor Thai Efexor drug information.
- Türk Efexor Kullanma Talimati Turkish Efexor Instructions for Use (PIL)
- UK Efexor XL SPC
- UK Efexor XL PIL
- Tiếng Việt Venlafaxin Thông tin thuốc Vietnamese Venlafaxin Drug Information
Other Review Sites
- Everyday Health Reviews
- AskaPatient Drug Ratings
- PatientsLikeMe Treatment Report
- DailyStrength Reviews
- WebMD User Reviews & Ratings
- Drugs.com User Reviews
Other Sites of Interest
- ChemSpider’s Venlafaxine page
- DrugBank’s venlafaxine page
- Drugsdb.com Effexor Page
- PharmGKB’s venlafaxine page
- PubChem’s venlafaxine page
- Official US Effexor XR Page
- Current Effexor XR PI Sheet - assuming they don’t move it.
- The site has nothing more than a medication guide, a discount card, and a link to Pfizer’s patient assistance program for cheap, or even free, meds and doctors.
- Unless you’re reading this on a computer at a public library or a friend’s apartment, you probably make too much money or have too many other resources to qualify.
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- Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. The British Journal of Psychiatry (2006) 189:124-131 R. M. Post, MD; L. L. Altshuler, MD; G. S. Leverich, MSW; M. A. Frye, MD; W. A. Nolen, MD; R. W. Kupka, MD, PhD; T. Suppes, MD; S. McElroy, MD and P. E. Keck, MD; K. D. Denicoff, MD; H. Grunze, MD; J. Walden, MD; C. M. R. Kitchen, PhD; J. Mintz, PhD
- Antidepressants in Bipolar Disorder: No Benefit, Possible Harm medscape.com May 30, 2013 Caroline Cassels
- Randomized, Double-Blind, Placebo-Controlled Crossover Trials of Venlafaxine for Hot Flashes After Breast Cancer The Oncologist January 2007 vol. 12 no. 1 124-135 Janet S. Carpenter, Anna Maria Storniolo, Shelley Johns, Patrick O. Monahan, Faouzi Azzouz, Julie L. Elam, Cynthia S. Johnson and Richard C. Shelton
- Prophylaxis of migraine: open study with venlafaxine in 42 patients Arq. Neuro-Psiquiatr. vol.56 n.4 São Paulo Dec. 1998 Dr. Estevão Demétrio Nascimento
- Venlafaxine versus amitriptyline in the prophylactic treatment of migraine: randomized, double-blind, crossover study Clinical Neurology and Neurosurgery 107 (2004) 44–48 Serpil Bulut, M. Said Berilgen, Aslihan Baran, Aslan Tekatas, Murad Atmaca, Bulent Mungen
- Modification of morphine analgesia by venlafaxine in diabetic neuropathic pain model. Pharmacological Reports 2012, 64, 1267-1275 Cegielska-Perun K, Bujalska-Zadrożny M, Makulska-Nowak HE.
- Efficacy and tolerability of venlafaxine extended release in patients with major depressive disorder. Psychiatria Danubina, 2010; Vol. 22, No. 3, pp 413–417 Plesničar BK
- Assessing Rates and Predictors of Tachyphylaxis During the Prevention of Recurrent Episodes of Depression With Venlafaxine ER for Two Years (PREVENT) Study. Psychopharmacol Bull. 2009; 42(3): 5–20. Dr. Anthony J. Rothschild, MD, Dr. Boadie W. Dunlop, MD, Dr. David L. Dunner, MD, Dr. Edward S. Friedman, MD, Dr. Alan Gelenberg, MD, Dr. Peter Holland, MD, Dr. James H. Kocsis, MD, Dr. Susan G. Kornstein, MD, Dr. Richard Shelton, MD, Dr. Madhukar H. Trivedi, MD, Dr. John M. Zajecka, MD, Dr. Corey Goldstein, MD, Dr. Michael E. Thase, MD, Dr. Ron Pedersen, MD, and Dr. Martin B. Keller, MD
- Psychopharmacology Research Tutorial for Practitioners - Antidepressant Drugs: Is a Dual Mechanism Better? Primary Psychiatry 2004;11(8):17-18 Donald S. Robinson, MD
- Stahl, Stephen M. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition Cambridge University Press 2008. ISBN:978–0521673761
- Julien, Robert M. Ph.D, Claire D. Advokat, and Joseph Comaty Primer of Drug Action: A comprehensive guide to the actions, uses, and side effects of psychoactive drugs 12th edition Worth Publishers 2011. ISBN:978–1429233439
- Diamond, Ronald J., MD Instant Psychopharmacology 2nd Edition W.W. Norton 2002. ISBN:978–0393703917
- Drummond, Edward, MD The Complete Guide to Psychiatric Drugs John Wiley & Sons 2000. ISBN:0471353701
- Effexor Prescribing Information
- Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier.
- PDR: Physicians’ Desk Reference 2010 64th edition
- Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.
- Dutch Patient Information Leaflet. Last retrieved 07 November 2014
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2 Although this may have something to do with the hypothesis that SSRIs & SNRIs work better for women while TCAs work better for men. While I buy into it, it is a fringe hypothesis, the data are still a bit sketchy, and it may be more truthiness than fact.
3 Although it doesn't taste anywhere near as good as lithium citrate syrup, but it is on par with chewable Lamictal.
4 While classified as a serotonin and norepinephrine reuptake inhibitor, the data are mixed when it comes to dopamine. Effexor may or may not have a therapeutic effect, albeit a minor one, on dopamine at a dosage above 300mg a day.
5 That's the term for a substance that isn't a chemical salt, such as venlafaxine hydrochloride or citalopram hydrobromide. Most antidepressants are salts, while most antiepileptic drugs and antipsychotics are not.
6 Seriously. They're practically psychopharmaceutical homeopathic remedies.
7 As well as being an indication of half of said conditions.
8 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.
9 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
10 I love how this translates to "Possibly effective."
11 As with Celica in Australia, I don't know how a drug company can, or why they would name one of their products after a car.
12 Doesn't Venalax, or anything ending with "alax" sound like a laxative? Given how SNRIs are much more likely to cause constipation than diarrhea that's another example of ironic branding.
13 Ironically, not a trade name in Iran.
14 Google translates this name to "Renal events." I guess anyone with kidney problems should avoid this one.
15 Translates to "raven", so they must be going after whatever the Korean equivalent to Goth is.
16 This one must be specifically for people with blonde hair.
17 Well, it is approved to treat anxiety.
18 I've also seen venlafaxini hydrochloridum as the active ingredient of some central- and eastern-European generics. I don't know enough (i.e. anything) about Latin to know if that is even correct usage or not. Let alone if venlafaxinum is correct. Latin generic names are all bullshit as far as I'm concerned.
19 Stahl will combine it with Remeron - a cocktail he calls "California Rocket Fuel" - for his patients who are truly, and dangerously alt.depressed.as.fuck, and who have not responded to anything else.
20 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
If you have any questions not answered here, please see the Crazymeds Effexor discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
|Last modified on Sunday, 16 November, 2014 at 10:57:45 by JerodPoore||Page Author Jerod Poore||Date created Monday, 25 April, 2011 at 11:53:36|
|“Effexor (venlafaxine): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © 2011 Jerod Poore||Published online 2011/04/25|
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
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