Venlafaxine: take care when settling

Nowadays, more and more people feel depressed, burned out and hopeless - depression has become a widespread disease. The antidepressant venlafaxine helps to counteract these symptoms by improving mood.

Venlafaxine in depression with anxiety

Venlafaxine is particularly suitable for people whose depression is accompanied by anxiety, because the drug is also used to treat panic attacks and other anxiety.

As with other antidepressants, there may be side effects when you take venlafaxine. Especially severe side effects may occur when venlafaxine is discontinued.

Venlafaxine: This is how the antidepressant works

Venlafaxine, like duloxetine, is a serotonin norepinephrine reuptake inhibitor (SNRI). Thus, these antidepressants are different from drugs such as fluoxetine or citalopram, which belong to the group of selective serotonin reuptake inhibitors (SSRIs).

In contrast to them, venlafaxine not only inhibits the reuptake of serotonin, but also norepinephrine and dopamine. However, the reuptake of norepinephrine and dopamine is only inhibited if venlafaxine is taken at a higher dose. A reduced level of the substances serotonin, norepinephrine and dopamine is considered to trigger depression.

Due to the blocking effect of venlafaxine, the substances can remain longer in the synaptic cleft and their concentration increases. This can lead to mood enhancement in depressed people. In addition, the drug is also helpful in anxiety disorders, as it solves anxiety. The correct dosage of venlafaxine should always be discussed with the attending physician.

Typical side effects of venlafaxine

Many sufferers experience more or less severe side effects in the first few days and weeks after taking an antidepressant. However, experience with Venlafaxin has been quite positive so far. The most common side effects with venlafaxine include nausea and headache.

Often there are also constipation, nervousness and insomnia, impotence and loss of appetite and weight loss. Occasionally venlafaxine may also lead to weight gain. From time to time it can also lead to arrhythmia, skin bleeding or hair loss. On the other hand, side effects such as seizures or hot flashes are rare.

In addition, recent studies have shown that long-term use of certain SSRI or SNRI-class drugs can hinder the work of the bone-degrading and anabolic cells. This can lead to increased bone fractures and an increased risk of osteoporosis. For which active substances this side effect apply in detail, but is still unclear. For a full list of the side effects of venlafaxine, please refer to the leaflet of the respective drug.

Increased suicidal risk as a result of ingestion

Similar to other antidepressants such as fluoxetine, the risk of suicide in the first weeks of therapy is also increased when venlafaxine is taken. Even after a change in dosage, the risk of suicide may increase.

Patients should observe themselves strictly during this time, but also be monitored by friends, relatives and the attending physician. The highest risk of suicide is seen in adolescents and young adults under 30 years of age.

From a medical point of view, the increased risk of suicide is due to the drive-enhancing effect of venlafaxine. Patients who have ever thought about suicide are more likely to actually implement their plans because of the antidepressant's effects.

Side effects when discontinuing venlafaxine

Although the side effects during the intake are usually rather small, but when discontinuing venlafaxine you can make unpleasant experiences. To avoid this, venlafaxine should not be stopped suddenly, but the dose of antidepressant should be reduced step by step. Nevertheless, there are often complaints when weaning (SSRI withdrawal syndrome).

Which symptoms as strongly occur, on the one hand on the treatment duration and the dosage of the active substance dependent, but also individually from patient to patient different.

The most common side effects after discontinuing venlafaxine include:

  • Tiredness and drowsiness,
  • Insomnia and other sleep disorders,
  • Nervousness and anxiety,
  • loss of appetite,
  • Trembling as well
  • Diarrhea and vomiting

In general, the symptoms should subside within two weeks, in some cases, the enumerated side effects are still noticeable two or three months after weaning.

Venlafaxine: Contraindicators

The antidepressant venlafaxine must not be taken if hypersensitivity to the active substance is present. Also, the drug must not be used together with monoamine oxidase inhibitors (MAO inhibitors), which also have an antidepressant effect. When switching from one antidepressant to another, there should be at least a two-week drug-free period in between.

In addition, venlafaxine must not be taken together with other substances that also have a serotonergic effect. These include all SSRI drugs, but also lithium, St. John's wort and triptans. The combination of venlafaxine with any of these drugs can cause the so-called serotonin syndrome, which can be fatal in the worst case scenario.

Interactions with venlafaxine

Patients who have kidney or liver disease should seek specific advice from the attending physician before taking venlafaxine. The same applies to patients who receive electroshock treatments or who suffer from seizures. Here, a cost-benefit calculation must be drawn up by the attending physician.

In addition, regular blood pressure monitoring is recommended while taking Venlafaxine, depending on the dose taken to increase blood pressure. It should also be noted that the reactivity is reduced by the active ingredient. This effect of venlafaxine is compounded with alcohol.

Venlafaxine in pregnant women and children

During pregnancy venlafaxine should only be used in particularly urgent cases and should be discussed with a doctor. Because the drug can lead to increased blood pressure, difficulty breathing or vomiting in the newborn. Venlafaxine should also be avoided during breast-feeding as the active ingredient also passes into breast milk. If ingestion is mandatory, the child should not be breastfed.

In children under the age of 18 years the side effects on the development are not fully explored, but it is certain that the intake of venlafaxine increases the aggressiveness of the children.

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