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Effexor Dangers

Effexor® (venlafaxine) is a medication used to treat a variety of psychiatric conditions, including but not limited to depression and general anxiety disorder (GAD). It can also be used to treat other conditions, but it is more commonly used as an antidepressant. It is in the SSNRI (Selective Serotonin Norepinephrine Reuptake Inhibitor) class. Typical dosing is between 37.5mg to 300mg. Patients are weaned onto the drug, to reduce side effects from starting the medication.

  1. FDA History

    • Effexor® was first approved by the Food and Drug Administration (FDA) in 2001 to treat depression. In 2005 the FDA issued a drug alert pertaining to the increase in suicidal behavior and thinking among patients taking Effexor®. Shortly after that, the FDA issued another, similar warning, this time pertaining to children and adolescents taking the drug. In 2006 the FDA issued yet another drug alert detailing the risk of developing a life threatening condition called "Serotonin Syndrome". Patients taking any drug in the SSRI (Selective Serotonin Reuptake Inhibitor) or SSNRI (Selective Serotonin Nor-epinephrine Inhibitor) are at risk for developing this syndrome.

      Also in 2006, the FDA issued a Black Box warning for Effexor® which stated the following, "Healthcare professionals are advised to prescribe Effexor® and Effexor XR® in the smallest quantity of capsules consistent with good patient management to reduce the risk of overdose" (DIOne). Several other Black box warnings have been issued for Effexor including increased risk of hypertension in some patient's as well acute narrow-angle glaucoma.

    The Dangers Associated with Effexor®

    • Other than the expected side effects of taking the medication as directed, which can include headache, nausea, stomach upset, and a myriad of other symptoms, the danger lay within both with the suicidal behavior it may cause as well as the adverse effects of missing a dose or weaning off of the drug completely.

    Risk of Suicidal Behavior

    • The first and most serious warning about Effexor® came in 2005 after the FDA reviewed evidence that suggested Effexor® and other related antidepressant were causing suicidal thoughts and behaviors in patients. According to DIOne, a medication management system used by hospitals, "although the FDA has not concluded that antidepressant drugs cause worsening depression or suicidality, health care providers should be aware that worsening of symptoms could be due to the underlying disease or might be a result of drug therapy." The FDA suggests that patients taking Effexor® be closely monitored by a trained physician for early warning signs that the drug may either be causing the suicidal behavior or that the drug is not being effective to alleviate the patients depression.

    Risk of Serotonin Syndrome

    • There has been an increasing awareness in recent years of the dangers and risks of developing serotonin syndrome when attempting to stop or withdraw from SSRIs and SSNRIs. Dr. Daniel M. Campagne, PhD wrote an article in July 2005, "Venlafaxine and Serious Withdrawal Symptoms: Warning to Drivers" that details these symptoms. According Dr. Campagne, the following symptoms are severe in many cases: agitation, anorexia, anxiety, confusion, problems with coordination, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting.

      These symptoms can drastically impair a patient's ability to perform daily functions and typically affect overall quality of life. He further makes the statement that severe withdrawal symptoms can begin shortly after a missed dose (due to the medication's short half life) and that these symptoms have the ability to impair a person's coordination and fine motor skills. Thus it is considered extremely dangerous for patients that are suffering from these symptoms to drive a car or operate heavy machinery, or do any physical or mental activity that could cause harm to themselves or others.

    Considerations

    • The physicians that most often prescribe Effexor® are general practitioners, not trained psychiatrists and may be unaware of the seriousness of the withdrawal syndrome. Patients have been told to wean off of Effexor® in the typical fashion, such as one pill every other day for two weeks and then stop. However, this method intensifies the withdrawal symptoms and has the ability to cause serious and life threatening conditions. Patients considering taking Effexor® to treat depression should do their own research and make sure they are making an informed decision regarding the best course of action for their mental health.

      Patients already on Effexor® who are considering weaning off are strongly encouraged not to stop cold turkey. To stop suddenly can cause in influx of severe symptoms. Patients should consult their physician first and not take any action unless they are under close supervision by that physician.

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