Venlafaxine is the first of a new class of antidepressants -- the phenethylamines -- that inhibit the reuptake of serotonin, norepinephrine and, to a lesser extent, of dopamine. Inhibiting reuptake of norepinephrine as well as serotonin is thought to give venlafaxine a broader spectrum of activity. In clinical trials, 68% of patients with major depression showed significant improvements in depression scores, compared with 31% of controls. In one comparative trial, venlafaxine helped 62% of patients hospitalized with serious _melancholic_ depression, compared with only 39% of patients receiving fluoxetine. There are anecdotal reports of patients who were resistant to fluoxetine, shock therapy, and other antidepressants but responded fully to venlafaxine.

Reprinted from the February 1994 issue of Medical Sciences Bulletin, published by Pharmaceutical Information Associates, Ltd.

Physicians are advised to discuss the following issues with patients for whom they prescribe Effexor XR (venlafaxine hydrochloride) extended-release capsules: Interference with Cognitive and Motor Performance Clinical studies were performed to examine the effects of venlafaxine on behavioral performance of healthy individuals. The results revealed no clinically significant impairment of psychomotor, cognitive, or complex behavior performance. However, since any psychoactive drug may impair judgment, thinking, or motor skills, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that venlafaxine therapy does not adversely affect their ability to engage in such activities.

Wyeth Laboratories Inc. A Wyeth-Ayerst Company Philadelphia, PA 19101 CI 5044-6 Revised September 11, 2000

Are nightmares a side effect of Effexor? I have a question about the drug Effexor. I have been taking it for about a year. I had taken about every other kind of anti-depressant prior to that but only Effexor had the desired result. I take 225 mg. daily: two 75 mg. pills at bedtime and one in the morning. Within the last month, something unusual has started happening. I have been waking at night with absolutely horrific nightmares. Prior to waking, I am told that I'm yelling, swinging, kicking, and sometime falling out of bed. Could this be a side-effect of Effexor or is something else happening? Is it possible for a side effect to not show up for a year? I am a 52-year-old male working as a computer consultant. I have been diagnosed with depression for 8 years or more. Other medications had no side-effects but not much of any positive effect either.
Thank you for any information.

In response to your question, there is a slight incidence of abnormal dreams associated with venlafaxine use. The character of the dream was not described, so we are unable to determine the definition of abnormal, but there is evidence of central nervous system anomolies. There also a number of different causes for nightmares besides the medication, such as fever, fatigue, and underlying psychologic disorders. Venlafaxine could potentiate other problems thus increasing dream activity. Evaluation by your physician is mandatory to rule out all possible causes for the change in behavior. The answer may be very simple or very complex , unfortunately we aren't the experts on this case. Let us know if we can help with further information.

Does Effexor cause weight gain or weight loss? I thought that a side effect of effexor was a reduction in appetite. A relative of mine that has been taking it for about a year seems to be gaining weight. What might be the cause?

I have been taking effexor (3 X 37.5/day) for two months. During this time I have gained close to 6 pounds. As a triathlete, I exercise heavily on a daily basis and keep a log of my food intake as well. I have neither increased my food consumption nor decreased any exercise or racing levels. Has there been any recorded data regarding effexor and weight fluctuation?

After a check with the Wyeth-Ayerst Labs, manufacturer of Effexor, I learned about several reports of weight gain in patients using Effexor. The cause is undetermined.

Anorexia and weight loss are known side effects of Effexor.

enlafaxine is typically taken in doses of 75 mg to 225 milligrams (mg) per day, although some people will respond to slightly lower or slightly higher doses. Typical side effects include nausea, dizziness, sedation, sweating, dry mouth, nervousness or shakiness, and sexual dysfunction. A small percentage of patients experience a rise in their blood pressure which is usually dose-related, and patients who are on venlafaxine should have their blood pressure monitored.

Effexor (venlafaxine) is an antidepressant from a relatively newer class of medications called NSRIs, or Norepinephrine and Serotonin Re-uptake Inhibitors. These medications differ from the more well-known SSRIs (Serotonin Selective Reuptake Inhibitors), which include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), and Celexa (citalopram). They differ in that they work on the receptor sites for two different brain chemicals, norepinephrine and serotonin, instead of just working on the serotonin receptor site in the brain.

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