Active Ingredients

Venlafaxine – Effect, Application & Risks


Venlafaxine is a drug from the drug class of antidepressants , which belongs to the serotonin-norepinephrine reuptake inhibitors and is used to treat depression and anxiety disorders .

What is venlafaxine?

Venlafaxine is used to treat depression and anxiety disorders. Rarely, a treating doctor prescribes venlafaxine for obsessive-compulsive disorders . Like many other antidepressants, venlafaxine is a serotonin-norepinephrine reuptake inhibitor.

However, the drug is not one of the drugs of first choice used in the acute treatment of depressive illnesses. There is no treatment advantage compared to cheaper non-selective monoamine reuptake inhibitors, so-called tri- and tetracyclic antidepressants, and selective serotonin reuptake inhibitors. In addition, serious side effects can develop while taking venlafaxine and after stopping the drug in question .

Pharmacological action

Venlafaxine is a so-called serotonin norepinephrine reuptake inhibitor (SSNRI). This relatively new group of antidepressants exerts its effects on the central nervous system . In certain synapses of the brain , the drug binds to substances that transport serotonin and norepinephrine . Serotonin is a tissue hormone and neurotransmitter at the same time. In the central nervous system, serotonin influences almost all brain functions. It has an effect on cognition , sleep , body temperature regulation and mood .

By stimulating the cerebral cortex , serotonin inhibits aggressiveness and impulsiveness . Due to its mood-enhancing effect, serotonin is often referred to as the happiness hormone. From a neurochemical point of view, depressive moods can often be traced back to a lack of serotonin.

Norepinephrine is also a neurotransmitter and hormone at the same time. The neurotransmitter exerts its effects both in the central nervous system and in the sympathetic nervous system . The effect in the central nervous system is similar to the effect of serotonin.

The drug venlafaxine inhibits the reuptake of neurotransmitters from the synaptic cleft into the cells . As a result, the active substance increases the transmitter concentration outside the cells, so that an amplification of the signal develops. As a result, venlafaxine mediates an antidepressant effect.

Medical Application & Use

Medicines containing venlafaxine are used to treat depression and anxiety disorders. These include generalized anxiety disorder, social anxiety disorder and panic disorder. In generalized anxiety disorder, fear becomes independent. Social anxiety disorder, on the other hand, is one of the phobic disorders. Those affected suffer from pronounced fears in social situations.

Venlafaxine is used to treat panic disorder with and without agoraphobia . With panic disorder, patients experience sudden anxiety attacks that are unrelated to real dangers. Agoraphobia is popularly known as claustrophobia.

Venlafaxine is also indicated for maintenance therapy in depression and anxiety disorders and to prevent recurrences, i.e. in the prevention of recurrences. It can show good success in previously failed therapy attempts in the treatment of attention deficit hyperactivity disorder .

Furthermore, the active substance is also used for the treatment of diabetic polyneuropathy . Diabetic polyneuropathy is a disease of the peripheral nervous system that occurs in the context of diabetes mellitus . If venlafaxine is used for this purpose, it is an off-label use. This means that the medicine is being used outside of the uses approved by the Medicines Agency.

Risks & side effects

Side effects occur mainly at the beginning of taking venlafaxine. This leads to gastrointestinal complaints , increased restlessness and diffuse, indefinable fears. Psychotic reactions can also occur. In the case of a psychosis , those affected suffer from an extensive loss of contact with reality. These psychotic states are probably the result of the dopaminergic effects of venlafaxine.

In addition to increases in blood pressure and heart problems, increased sweating and increased night sweating can be observed. Nausea is another side effect that is very common. Around 10 percent of patients suffer from nausea and vomiting . There are also symptoms such as loss of appetite , dizziness , constipation , nervousness and tremors .

Teeth grinding and blurred vision are also common side effects. Some patients experience tiredness and drowsiness while taking venlafaxine . Disorders of the libido and the loss of sexual functions are very common .

The evaluation of clinical studies from the USA also showed that venlafaxine can increase suicidal tendencies by a factor of 5 in users under the age of 25. However, these results could not be confirmed by a meta-study from 2012. Nevertheless, many experts advise against prescribing venlafaxine for the initial treatment of depression.

Another risk with venlafaxine administration is SSRI withdrawal syndrome . Venlafaxine should always be tapered off gradually and never stopped abruptly. Otherwise withdrawal symptoms such as circulatory problems , dizziness , fear of heights , motor disorders, daytime sleepiness, diarrhea , constipation , mood swings and severe depression can occur. Withdrawal symptoms of this type can occur up to four weeks after stopping the drug.

In combination with other serotonergic agents, venlafaxine can lead to the life-threatening serotonin syndrome . Therefore, the drug must not be used together with St. John’s wort , lithium, triptans , serotonin reuptake inhibitors, sibutramine and tramadol . The simultaneous administration of MAO inhibitors and CYP3A4 inhibitors is also contraindicated. It should also be noted that venlafaxine may potentiate the effects of haloperidol , metoprolol and risperidone .

Venlafaxine may only be prescribed during pregnancy in exceptional cases Newborns whose mothers took venlafaxine in the last trimester of pregnancy may experience trouble sleeping , seizures , shortness of breath , shaking, constant crying, and irritability . Whether mothers should breastfeed while taking venlafaxine is still controversial. In any case, close observation of the child is necessary.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.