|
|
Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine
reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993.
It is prescribed for the treatment of clinical depression and anxiety
disorders. Due to the pronounced side effects and suspicions that
venlafaxine may significantly increase the risk of suicide it is
not recommended as a first line treatment of depression. However,
it is often effective for depression not responding to SSRIs. Venlafaxine
was the sixth most widely-used antidepressant based on the amount
of retail prescriptions in the US (17.1 million) in 2006.
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.
A popular magazine Consumer Reports, which in 2004 had 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.
Error 404 - not found
|
