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EFFEXOR

EFFEXOR
Effexor

DESCRIPTION / DEFINITIONS: Effexor® (venlafaxine) is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) reuptake inhibitor.

ABUSE: Effexor is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE: Half life and metabolism, Black Box Warning.

SIDE EFFECTS: Heart attack, suicide, paranoid reactions (see list below).

WITHDRAWAL SYMPTOMS: Nausea, insomnia, headache (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Effexor® (venlafaxine) is a selective serotonin and norepinephrine reuptake inhibitor (“SNRI”).

Although there are no medical tests to determine if a person has insufficient serotonin or norepinephrine, SNRI drugs like Effexor increase the amount of serotonin norepinephrine in the brain. According to its label, “The mechanism of the antidepressant action of venlafaxine in humans is believed to be associated with its potentiation of neurotransmitter activity in the CNS.”

ABUSE

Effexor is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of venlafaxine is between five to seven hours. The half life of Effexor’s active metabolite, O-desmethylvenlafaxine (ODV) is between 11 to 13 hours. The active metabolite is the substance produced when Effexor is metabolized.

Effexor is mainly metabolized through the P450 pathway in the liver and the enzyme primarily handling the metabolism is CYP2D6.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

BLACK BOX WARNING

The Food and Drug Administration (FDA) has decided that some drugs pose very serious risks and have required these drugs have what is called a black box warning. Effexor has a black box warning. Here is the warning.

WARNING: Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Effexor or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Effexor is not approved for use in pediatric patients.

(See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.)

SIDE EFFECTS

The following information is taken from the Effexor label:

  • abdominal pain

  • abnormal dreams

  • abnormal

  • ejaculation/orgasm

  • abnormal gait

  • abnormal speech

  • abnormal vision

  • abnormalities of unspecified liver function tests

  • abnormality of accommodation

  • abortion

  • accidental injury

  • acne

  • agitation

  • agranulocytosis

  • akathisia

  • akinesia

  • albuminuria

  • alcohol abuse

  • alcohol intolerance

  • alkaline phosphatase increased

  • alopecia

  • amenorrhea

  • amnesia

  • anaphylaxis

  • anemia

  • angina pectoris

  • angle-closure glaucoma

  • anorexia

  • anuria

  • anxiety

  • aortic aneurysm

  • apathy

  • aphasia

  • aplastic anemia

  • appendicitis

  • arrhythmia

  • arteritis

  • arthralgia

  • arthritis

  • arthrosis

  • asthenia

  • asthma

  • ataxia

  • atelectasis

  • back pain

  • bacteremia

  • balanitis

  • basophilia

  • bigeminy

  • bilirubinemia

  • bladder pain

  • bleeding time increased

  • blepharitis

  • blurred vision

  • bone pain

  • bone spurs

  • bradycardia

  • bradykinesia

  • breast discharge

  • breast engorgement

  • breast enlargement

  • breast pain

  • brittle nails

  • bronchitis

  • bruxism

  • buccoglossal syndrome

  • BUN increased

  • bundle branch block

  • bursitis

  • calcium crystalluria,

  • capillary fragility

  • carcinoma

  • cardiac arrhythmias including atrial fibrillation

  • cardiovascular disorder (mitral valve and circulatory disturbance)

  • cataract

  • catatonia

  • cellulitis

  • cerebral ischemia

  • cerebrovascular accident

  • cervicitis

  • cheilitis

  • chest congestion

  • chest pain

  • chest pain substernal

  • chills

  • cholecystitis

  • cholelithiasis

  • chromatopsia

  • circumoral paresthesia

  • CNS stimulation

  • colitis

  • confusion

  • congenital anomalies

  • congestive heart failure

  • conjunctival edema

  • conjunctivitis

  • constipation

  • contact dermatitis

  • corneal lesion

  • coronary artery disease

  • cough increased

  • CPK increased

  • creatinine increased

  • cyanosis

  • cystitis

  • deafness

  • decreased pupillary reflex

  • deep vein thrombophlebitis

  • dehydration

  • delirium

  • delusions

  • dementia

  • depersonalization

  • depression

  • diabetes mellitus

  • diarrhea

  • diplopia

  • dizziness

  • dry eyes

  • dry mouth

  • dry skin

  • duodenitis

  • dysmenorrhea

  • dyspepsia

  • dysphagia

  • dyspnea

  • dystonia

  • dysuria

  • ecchymosis

  • eczema

  • edema

  • EKG abnormalities such as QT prolongation

  • emotional lability

  • endometriosis

  • eosinophilia

  • epistaxis
  • eructation

  • erythema multiforme

  • erythema nodosum

  • esophageal spasm

  • esophagitis

  • euphoria

  • exfoliative dermatitis

  • exophthalmos

  • extrapyramidal symptoms (including dyskinesia and tardive dyskinesia)

  • extrasystoles

  • eye pain

  • face edema

  • facial paralysis

  • feeling drunk

  • female lactation

  • fever

  • fibrocystic breast

  • first-degree atrioventricular block

  • flatulence

  • flu syndrome

  • furunculosis

  • gastritis

  • gastroenteritis

  • gastrointestinal hemorrhage

  • gastrointestinal ulcer

  • gingivitis

  • glaucoma

  • glossitis

  • glycosuria

  • goiter

  • gout

  • Guillain-Barre Syndrome

  • gum hemorrhage

  • gynecomastia (male)

  • hair discoloration

  • hallucinations

  • headache

  • healing abnormal

  • heart arrest

  • hematemesis

  • hematuria

  • hemochromatosis

  • hemoptysis

  • hemorrhage (including eye and gastrointestinal bleeding)

  • hemorrhoids

  • hepatic events (including GGT elevation

  • hepatitis

  • hirsutism

  • hostility

  • hyperacusis

  • hypercalcinuria

  • hyperchlorhydria

  • hypercholesteremia

  • hyperesthesia

  • hyperglycemia

  • hyperkalemia

  • hyperkinesia

  • hyperlipemia

  • hyperphosphatemia

  • hypertension

  • hyperthyroidism

  • hypertonia

  • hyperuricemia

  • hyperventilation

  • hypesthesia

  • hypocholesteremia

  • hypoglycemia

  • hypokalemia

  • hypokinesia

  • hypomenorrhea

  • hyponatremia

  • hypophosphatemia

  • hypoproteinemia

  • hypotension

  • hypothyroidism

  • hypotonia

  • hypoventilation

  • hypoxia

  • ileitis

  • impaired coordination and balance

  • impotence

  • impulse control difficulties

  • incoordination

  • increased appetite

  • increased salivation

  • infection

  • insomnia

  • intentional injury

  • interstitial lung disease

  • intestinal obstruction

  • involuntary movements

  • jaundice

  • keratitis

  • kidney calculus

  • kidney function abnormal

  • kidney pain

  • labyrinthitis

  • laryngismus

  • laryngitis

  • larynx edema

  • LDH increased

  • leg cramps

  • leucorrhea

  • leukocytosis

  • leukoderma

  • leukopenia

  • libido decreased

  • libido increased

  • lichenoid dermatitis

  • liver damage, necrosis, or failure; and fatty liver)

  • loss of consciousness

  • lymphadenopathy

  • lymphocytosis

  • maculopapular rash

  • malaise

  • manic reaction

  • mastitis

  • melena

  • menopause

  • menorrhagia

  • metrorrhagia

  • migraine

  • miosis

  • moniliasis

  • mouth ulceration

  • mucocutaneous hemorrhage

  • multiple myeloma

  • myalgia

  • myasthenia

  • mydriasis

  • myocardial infarct

  • myoclonus

  • myopathy

  • nausea

  • neck pain

  • neck rigidity
  • nervousness

  • neuralgia

  • neuritis

  • neuroleptic malignant syndrome-like events

  • neuropathy

  • neutropenia

  • night sweats

  • nocturia

  • nystagmus

  • oliguria

  • oral moniliasis

  • orchitis

  • orgasm disturbance

  • osteoporosis

  • osteosclerosis

  • otitis externa

  • ovarian cyst

  • pain

  • pallor

  • palpitation

  • pancreatitis

  • pancytopenia

  • panic

  • papilledema

  • paranoid reaction

  • paresis

  • paresthesia

  • parosmia

  • parotitis

  • pathological fracture

  • pelvic pain

  • periodontitis

  • peripheral vascular disorder (mainly cold feet and/or cold hands)

  • petechial rash

  • pharyngitis

  • photophobia

  • photosensitivity reaction

  • plantar fasciitis

  • pleurisy

  • pneumonia

  • polyuria

  • postural hypotension

  • proctitis

  • prolactin increased

  • prolonged erection

  • prostatic disorder (prostatitis and enlarged prostate)

  • pruritus

  • psoriasis

  • psychosis

  • psychotic depression

  • pulmonary embolus

  • purpura

  • pustular rash

  • pyelonephritis

  • pyuria

  • rash

  • rectal hemorrhage

  • reflexes decreased

  • reflexes increased

  • renal failure

  • retinal hemorrhage

  • rhabdomyolysis

  • rheumatoid arthritis

  • rhinitis

  • salpingitis

  • scleritis

  • seborrhea

  • seizure

  • serotonin syndrome

  • SGOT (AST) increased

  • SGPT (ALT) increased

  • shock-like electrical sensations

  • sinusitis

  • skin atrophy

  • skin discoloration

  • skin hypertrophy

  • skin striae

  • sleep apnea

  • soft stools

  • somnolence

  • stomatitis

  • stupor

  • subconjunctival hemorrhage

  • suicidal ideation

  • suicide attempt

  • supraventricular tachycardia

  • sweating

  • syncope

  • syndrome of inappropriate antidiuretic hormone secretion

  • taste loss

  • taste perversion

  • tendon rupture

  • tenosynovitis

  • thinking abnormal

  • thirst

  • thrombocythemia

  • thrombocytopenia

  • thrombophlebitis

  • thyroid nodule

  • thyroiditis

  • tinnitus

  • tongue discoloration

  • tongue edema

  • torsade de pointes

  • torticollis

  • toxic epidermal necrolysis/Stevens-Johnson Syndrome

  • trauma

  • tremor

  • trismus

  • twitching

  • uremia

  • urinary frequency

  • urinary incontinence

  • urinary retention

  • urinary urgency

  • urolithiasis

  • urticaria

  • uterine hemorrhage

  • uterine spasm

  • uveitis

  • vaginal dryness

  • vaginal hemorrhage

  • vaginitis

  • vasodilation

  • ventricular extrasystole

  • ventricular fibrillation

  • ventricular tachycardia

  • vertigo

  • vesiculobullous

  • visual field defect

  • voice alteration

  • vomiting

  • weight gain

  • weight loss

  • withdrawal syndrome

  • yawning

WITHDRAWAL SYMPTOMS

Effexor can be a very difficult drug to stop taking. Here are some of the Effexor withdrawal symptoms:

  • agitation

  • confusion

  • depression

  • diarrhea

  • dizziness

  • dreams, including vivid dreams

  • drowsiness

  • electric shock-like sensations
  • fatigue/malaise

  • feelings of being hot or cold

  • feelings of unreality

  • flatulence

  • flu-like feelings

  • headache

  • insomnia
  • irritability

  • mood swings

  • muscle spasms

  • nausea

  • other strange tingling or painful sensations

  • sweating

  • tremor

TREATMENT

Withdrawal from Effexor should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements for biological balancing. Call us to talk to a Detox Advisor.
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