Venlafaxine

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In medicine and neuropharmacology, venlafaxine is a second generation antidepressant that has unusual chemistry: it inhibits the reuptake of several neurotransmitters depending on dose. In other words, it is an atypical second-generation drug that is neither a pure selective serotonin reuptake inhibitor (SSRI), a pure selective norepinephrine reuptake inhibitor (SNRI), or an equal inhibitor of both. To a lesser extent, it inhibits dopamine reuptake. [1]

History

Effexor brand of venlafaxine was approved by the Food and Drug Administration in the United States with a New Drug Application (NDA) in 1993.[2] A generic version was approved with a NDA in 2008.[3]

Generic versions of the time-release form are also available.

Pharmacology

Administration

Distribution

Metabolism

At the basic dosage level, it increases serotonin levels in synaptic gaps, by inhibiting presynaptic reuptake. With this

Excretion

Toxicity

Clinical uses

Depression

In a meta-analysis of eight trials of venflaxine versus the pure SSRIs fluoxetine, fluvoxamine and paroxetine, it had a superior rate of remission of depression. This improvement was evident versus placebo in week 2 of treatment, while the other drugs were superior to placebo only after 4 weeks.[4] When extended-release venlafaxine was compared to extended-release bupropion, efficacy was comparable but bupropion had a better side effect profile.[5]

Neuropathic pain

"TCAs and venlafaxine have NNTs of approximately three."[6]

External links

The most up-to-date information about Venlafaxine and other drugs can be found at the following sites.


References

  1. Partridge SJ; MacIver DH; Solanki T (2000), "(Abstract) A depressed myocardium.", J Toxicol Clin Toxicol 38 (4): 453-5
  2. Anonymous. Drugs@FDA for FDA Application No. 020151. U S Food and Drug Administration
  3. Anonymous. Drugs@FDA for FDA Application No. 022104. U S Food and Drug Administration
  4. Thase ME; Entsuah R; Rudolph RL (2001), "/Remission%20Rates%20During%20Treatment%20With%20Venlafaxine%20Or%20Selective%20Serotonin%20Reuptake%20Inhibitors.pdf Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors", Br. J. Psychiatry
  5. Thase ME; Clayton AH; Haight BR; Thompson AH; Modell JG; Johnston JA (2006), J Clin Psychopharmacol 26 (5): 482-8
  6. Saarto T, Wiffen PJ (2007). "Antidepressants for neuropathic pain.". Cochrane Database Syst Rev (4): CD005454. DOI:10.1002/14651858.CD005454.pub2. PMID 17943857. Research Blogging.