Case Evaluation

Effexor: Effexor Overview

Generic Name: venlafaxine

Effexor Description: Effexor (venlafaxine hydrochloride) is a synthetic derivative of phenthylamine and a prescription antidepressant first marketed by Wyeth in 1993 under the names Effexor (tablets) and Effexor XR (extended-release). Since the drug is currently under patent, a generic will not be available until 2008 in America, and the European patent will hold until 2017.Venlafaxine is used in treating panic disorder, generalized anxiety disorder (GAD), social anxiety disorder (SAD; social phobia), and depression.

Classification: Antidepressant

Clinical Pharmacology:

The mechanism of action in humans is thought to be associated with its potentiation of neurotransmitter activity in the central nervous system. Preclinical studies have shown Venlafaxine and its active metabolite to be potent inhibitors of serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake.

Indications and Dosage:

Effexor is indicated for treating major depressive disorder. A major depressive episode implies persistent depressed or dysphoric mood that usually interferes with daily functioning – nearly everyday for at least 2 weeks. The recommended initial dosage for Effexor is 75mg/day, given in two or three divided doses with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150mg/day, increased further to 225mg/day if needed. When raising dosages, incremental increases of up to 75mg/day should be made in intervals of no less than 4 days. In outpatient settings, there was no evidence of efficacy in doses greater than 225mg/day for moderately depressed persons, but more severely depressed inpatients responded to a mean dose of 350mg/day. Certain patients, including more severely depressed patients, may then respond to even higher doses, up to a maximum of 375mg/day, normally in three divided doses.

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