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Venlafaxine

SNRI for MDD, GAD, panic, social anxiety.

Aliases (2)
Effexor · Effexor XR
TYPICAL DOSE
37
Daily
ROUTE
CYCLE
STORAGE

Overview

What is Venlafaxine?

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) FDA-approved for major depressive disorder, generalized anxiety disorder, social anxiety, and panic disorder. Marketed as Effexor and Effexor XR, it is one of the most widely prescribed SNRIs.

Key Benefits

Treats depression and anxiety effectively, helpful for chronic pain (neuropathic) and hot flashes, dual mechanism may benefit treatment-resistant or melancholic depression, and dose-dependent activation can boost energy and motivation.

Mechanism of Action

At low doses primarily inhibits serotonin reuptake (SERT). At doses above ~150 mg/day, also inhibits norepinephrine reuptake (NET). At very high doses, weak dopamine reuptake inhibition emerges. Dose-dependent transition explains the spectrum of clinical effects from SSRI-like to broad SNRI-like activity.

Pharmacokinetics

·
PeakHalf-life
Approximate curve — visual aid only, not data-precise PK

What to Expect

  • Week 1
    Tolerability and dose-response.
  • Week 2-4
    Early effect window.
  • Week 4-8
    Peak benefit assessment.
  • Week 8+
    Cycle decision point.

Side Effects & Safety

  • Common (>10%): Nausea, sweating, sexual dysfunction, ↑ BP (dose-dependent, monitor at >150mg), insomnia.
  • Less common (1-10%): Tremor, anorexia, ↑ HR, dry mouth.
  • Rare-serious (<1%): Serotonin syndrome, hyponatremia, hypertensive crisis, severe withdrawal syndrome (functional), suicidal ideation <25 yo.
  • Specific watch periods: BP at every visit; first 4 weeks for activation/SI.

References

PMID 29477251

pubmed.ncbi.nlm.nih.gov · 2018

Cipriani 2018 network MA.

View Study

PMID 30032535

pubmed.ncbi.nlm.nih.gov

Antidepressant discontinuation symptoms (Davies + Read).

View Study

PMID 21199948

pubmed.ncbi.nlm.nih.gov

Venlafaxine BP elevation review.

View Study

PMID 16390886

pubmed.ncbi.nlm.nih.gov

STAR*D venlafaxine arm.

View Study

PMID 18316756

pubmed.ncbi.nlm.nih.gov

SNRI sexual dysfunction.

View Study
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