Venlafaxine: Caution when stopping
Nowadays, more and more people feel down, burned out and hopeless – depression has become a widespread disease. The antidepressant venlafaxine helps against the symptoms mentioned by having a mood-enhancing effect.
Venlafaxine for depression with anxiety
Venlafaxine is particularly suitable for people whose depression is accompanied by anxiety, as the drug is also used to treat panic attacks and other anxiety disorders.
As with other antidepressants, side effects can occur when taking venlafaxine. Particularly severe side effects can happen when you stop taking venlafaxine.
Venlafaxine: How the antidepressant works
Venlafaxine, like duloxetine, is a serotonin-norepinephrine reuptake inhibitor (SNRI). This distinguishes these antidepressants from active ingredients such as fluoxetine or citalopram, which belong to the group of selective serotonin reuptake inhibitors (SSRI).
Unlike them, venlafaxine inhibits the reuptake of serotonin, norepinephrine and dopamine. However, the reuptake of norepinephrine and dopamine is only inhibited when venlafaxine is taken in higher doses. Reduced content of the substances serotonin, norepinephrine and dopamine is considered to trigger depression.
Due to the blocking effect of venlafaxine, the substances can stay longer in the synaptic cleft and their concentration increases. This can improve the mood of depressed people. In addition, the active ingredient is also helpful in anxiety disorders because it relieves anxiety. The correct venlafaxine dosage should always be discussed with the doctor treating you.
Typical side effects of venlafaxine
Many sufferers suffer from more or less severe side effects in the first days and weeks after starting to take an antidepressant. However, the experience with venlafaxine has been quite positive so far. The most common side effects of venlafaxine include nausea and headache.
Constipation, nervousness and insomnia, erectile dysfunction, loss of appetite and weight loss are also common. Occasionally, however, venlafaxine can lead to weight gain. Occasionally, cardiac arrhythmia, skin bleeding, or hair loss can occur. On the other hand, side effects such as seizures or hot flashes are rare.
Current studies have also shown that long-term use of certain active ingredients from the SSRI or SNRI group can impede bone-reducing and cell-building. This can lead to increased fractures and an increased risk of osteoporosis. However, it still needs to be determined in detail which active ingredients this side effect applies. For a complete list of venlafaxine side effects, please refer to the patient information leaflet with the medication.
Increased risk of suicide as a result of ingestion
Similar to other antidepressants, such as fluoxetine, the risk of suicide is increased when taking venlafaxine in the first few weeks of therapy. Even after changing the dosage, the risk of suicide may increase.
Patients should monitor themselves closely during this time, but friends and relatives should also monitor them and the doctor treating them. Adolescents and young adults under the age of 30 are at highest risk of suicide.
From a medical point of view, the increased risk of suicide is due to the drive-enhancing effect of venlafaxine. Patients, in particular, who have already thought about suicide are more willing to implement their plans due to the impact of the antidepressant.
Side effects of stopping venlafaxine
Admittedly, the side effects while taking it are usually relatively minor, but when you stop taking venlafaxine, you can have unpleasant experiences. To avoid this, if possible, venlafaxine should not be stopped suddenly, but the dose of the antidepressant should be reduced step by step. Nevertheless, symptoms often occur when weaning (SSRI discontinuation syndrome).
Which symptoms occur and how severe they are depends on the duration of treatment and the dosage of the active ingredient, but also varies from patient to patient.
The most common side effects after stopping venlafaxine include:
- tiredness and drowsiness,
- insomnia and other sleep disorders,
- nervousness and fear,
- loss of appetite,
- tremors as well
- diarrhoea and vomiting
The symptoms should subside within two weeks, but some of the side effects listed are still noticeable two or three months after stopping.
Venlafaxine: The contraindication
The antidepressant venlafaxine should not be taken if you are hypersensitive to the active ingredient. The active ingredient must also not be used with monoamine oxidase inhibitors (MAOIs), which also have an antidepressant effect. If you switch from one antidepressant to the other, there should be a drug-free phase of at least two weeks in between.
In addition, venlafaxine must not be taken together with other substances with a serotonergic effect. These include all SSRI active ingredients, lithium, St. John’s wort and triptans. If venlafaxine is combined with one of these drugs, the so-called serotonin syndrome can occur, which, in the worst case, can be fatal.
Interactions with venlafaxine
Patients with kidney or liver disease should seek specific advice from their doctor before taking venlafaxine. The same applies to patients who receive electric shock treatments or who suffer from seizures. In this case, a cost-benefit calculation must be drawn up by the doctor treating you.
Regular blood pressure monitoring is also recommended since venlafaxine can increase blood pressure, depending on the dose taken. It should also be noted that the active ingredient reduces the ability to react. This effect of venlafaxine is increased in combination with alcohol.
Venlafaxine in pregnant women and children
Venlafaxine should only be used during pregnancy in particularly urgent cases. It should be explicitly discussed with a doctor because the active ingredient can lead to increased blood pressure, breathing difficulties or vomiting in the newborn. Venlafaxine should also be avoided during breastfeeding, as the active ingredient is also excreted in breast milk. If the intake is necessary, the child should not be breastfed.
In children under 18 years of age, the side effects on development have not yet been thoroughly researched, but taking venlafaxine certainly increases the aggressiveness of children.