Why is Effexor prescribed?
Effexor is prescribed for the treatment of depression--that is, a continuing depression that interferes with daily functioning. The symptoms usually include changes in appetite, sleep habits, and mind/body coordination, decreased sex drive, increased fatigue, feelings of guilt or worthlessness, difficulty concentrating, slowed thinking, and suicidal thoughts.
Effexor XR is also prescribed to relieve abnormal anxiety (generalized anxiety disorder and social anxiety disorder). Generalized anxiety disorder is marked by persistent anxiety for a period of at least 6 months, accompanied by at least 3 of these 6 symptoms: restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbances.
Social anxiety disorder is marked by a persistent fear (avoidance, anxiousness, or distress) of social situations, exposure to unfamiliar people, or possible scrutiny by others. Social anxiety is considered abnormal if it causes someone to alter an otherwise normal routine or interferes with daily functioning. The disorder can also cause panic attacks.
Effexor must be taken 2 or 3 times daily. The extended-release form, Effexor XR, permits once-a-day dosing.
Most important fact about Effexor
Serious, sometimes fatal reactions have occurred when Effexor is used in combination with other drugs known as MAO inhibitors, including the antidepressants Nardil and Parnate. Never take Effexor with one of these drugs; and do not begin therapy with Effexor within 14 days of discontinuing treatment with one of them. Also, allow at least 7 days between the last dose of Effexor and the first dose of an MAO inhibitor.
How should you take Effexor?
Take Effexor with food, exactly as prescribed. It may take several weeks before you begin to feel better. Your doctor should check your progress periodically.
Take Effexor XR once at the same time each day. Swallow the capsule whole with water. Do not divide, crush, or chew it. However, if you have trouble swallowing pills, you may take Effexor XR by carefully opening the capsule and sprinkling the entire contents on a spoonful of applesauce, followed by a glass of water.
--If you miss a dose...
It is not necessary to make it up. Skip the missed dose and continue with your next scheduled dose. Do not take 2 doses at once.
--Storage instructions...
Store in a tightly closed container at room temperature. Protect from excessive heat and moisture.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Effexor.
• Side effects of Effexor may include:
Abnormal ejaculation/orgasm, anxiety, blurred vision, constipation, dizziness, dry mouth, impotence, insomnia, nausea, nervousness, sleepiness, sweating, tremor, vomiting, weakness, weight loss
• Side effects of Effexor XR may include:
Abnormal dreams, abnormal ejaculation, constipation, dizziness, dry mouth, headache, insomnia, nausea, nervousness, sleepiness, sweating, weakness, weight loss
Why should Effexor not be prescribed?
Never take Effexor while taking other drugs known as MAO inhibitors. (See "Most important fact about Effexor.") Also avoid Effexor if it has ever given you an allergic reaction.
Special warnings about Effexor
In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Effexor or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Effexor has not been studied in children or adolescents and is not approved for treating anyone less than 18 years old.
Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Effexor and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.
Your doctor will prescribe Effexor with caution if you have high blood pressure, heart, liver, or kidney disease or a history of seizures or mania (extreme agitation or excitability). You should discuss all of your medical problems with your doctor before taking Effexor.
Effexor sometimes causes an increase in blood pressure. If this happens, your doctor may need to reduce your dose or discontinue the drug.
Effexor also tends to increase the heart rate, especially at higher doses. Use Effexor with caution if you've recently had a heart attack, suffer from heart failure, or have an overactive thyroid gland.
Effexor may also cause cholesterol levels to rise in some patients who take it for 3 months or longer. This effect is more common among patients taking higher doses of Effexor.
Antidepressants such as Effexor may cause fluid retention, especially if you are an older adult.
Effexor may cause you to feel drowsy or less alert and may affect your judgment. Therefore, avoid driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness until you know how Effexor affects you.
Your doctor will check you regularly if you have glaucoma (high pressure in the eye), or you are at risk of developing it.
If you have ever been addicted to drugs, tell your doctor before you start taking Effexor.
If you develop a skin rash or hives while taking Effexor, notify your doctor. Effexor may also cause bleeding or bruising of the skin.
Do not stop taking the drug without consulting your doctor. If you stop suddenly, you may have withdrawal symptoms, even though Effexor does not seem to be habit-forming. Your doctor will have you taper off gradually.
Possible food and drug interactions when taking Effexor
Combining Effexor with MAO inhibitors could cause a fatal reaction. (See "Most important fact about Effexor.")
Although Effexor does not interact with alcohol, the manufacturer recommends avoiding alcohol while taking Effexor.
If you have high blood pressure or liver disease, or are elderly, check with your doctor before combining Effexor with cimetidine (Tagamet).
You should consult your doctor before combining Effexor with other drugs that affect the central nervous system, including lithium, migraine medications such as Imitrex, narcotic painkillers, sleep aids, weight-loss products such as phentermine, tranquilizers, antipsychotic medicines such as Haldol, and other antidepressants such as Celexa, Prozac, Tofranil, and Zoloft.
Effexor has been found to reduce blood levels of the HIV drug Crixivan. It's best to check with your doctor before combining Effexor with any other drug or herbal product.
Special information if you are pregnant or breastfeeding
The effects of Effexor during pregnancy have not been adequately studied. If you are pregnant or are planning to become pregnant, tell your doctor immediately. Effexor should be used during pregnancy only if clearly needed.
If Effexor is taken shortly before delivery, the baby may suffer withdrawal symptoms. It's also known that Effexor appears in breast milk and could cause serious side effects in a nursing infant. You'll need to choose between nursing your baby or continuing your treatment with Effexor.
Recommended dosage
EFFEXOR
The usual starting dose is 75 milligrams a day, divided into 2 or 3 smaller doses, and taken with food. If needed, your doctor may gradually increase your daily dose in steps of no more than 75 milligrams at a time up to a maximum of 375 milligrams per day.
If you have kidney or liver disease or are taking other medications, your doctor will adjust your dosage accordingly.
EFFEXOR XR
For both depression and anxiety, the usual starting dose is 75 milligrams once daily taken with food, although some people begin with a dose of 37.5 milligrams for the first 4 to 7 days. Your doctor may gradually increase the dose, in steps of no more than 75 milligrams, up to a maximum of 225 milligrams daily. As with regular Effexor, the doctor will make adjustments in your dosage if you have kidney or liver disease.
Overdosage
An overdose of Effexor, combined with other drugs or alcohol, can be fatal. If you suspect an overdose, seek medical attention immediately.
• Symptoms of Effexor overdose include:
Sleepiness, vertigo, rapid or slow heartbeat, low blood pressure, seizures, coma