About Effexor(Venlafaxine)

Venlafaxine hydrochloride (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is prescribed for the treatment of clinical depression and anxiety disorders. Due to the side effects and suspicions that venlafaxine may cause suicide it is not recommended as a first line treatment. However, it is often effective for depression not responding to SSRI. Venlafaxine was first introduced by Wyeth in 1993. It is the sixth antidepressant based on the amount of retail prescriptions in the US (17.1 million).

Approved

Venlafaxine is used primarily for the treatment of depression, generalized anxiety disorder, social anxiety disorder, and panic disorder in adults.

Depression

Venlafaxine was shown to be effective for depression in multiple double blind studies. Venlafaxine is similar in efficacy to trazodone and tricyclic antidepressants amitriptiline (Elavil) and imipramine and it was better tolerated than amitriptiline. Venlafaxine appears to have efficacy similar or somewhat better than sertraline (Zoloft) and fluoxetine (Prozac) depending on the criteria and rating scales used. In particular, higher doses of venlafaxine are more effective, and more patients achieved remission or were "very much improved". At the same time the efficacy was similar if the number of patients who achieved "response" or were "improved" was considered. A meta-analysis comparing venlafaxine and combined groups of SSRI or tricyclic antidepressants indicated superiority of venlafaxine. Based on the same set of criteria, venlafaxine was similar in efficacy to an atypical antidepressant bupropion (Wellbutrin); however, the remission rate was significantly lower for venlafaxine.Venlafaxine was also marginally inferior in efficacy to a newer SSRI escitalopram (Lexapro) and had twice higher frequency of the side effects, in particular, nausea, ejaculation disorder, somnolence and sweating.

Interestingly, a popular magazine Consumer Reports, which originally rated venlafaxine as the most effective among six commonly prescribed antidepressants, no longer recommends it. Fluoxetine, citalopram and bupropion have been chosen as Consumer Reports Best Buy drugs in the updated version of their guide, based upon effectiveness, safety, side effects, and cost.

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