Case Evaluation

Effexor: Effexor Side Effects

Side Effects :

The most frequent side effects of Effexor use include somnolence, nervousness, insomnia, dizziness, dry mouth, anxiety, changes in urination, fatigue, vertigo, vivid dreams, electric-shock like sensations, increased blood pressure, gastrointestinal distress, nausea, headache, asthenia, sweating, and abnormal ejaculation/orgasm/impotence in men. Rare to abnormal side effects may include cardiac arrhythmia, gas/stomach pain, abnormal vision, increased serum cholesterol, nervousness, agitation or increased anxiety, feelings of depression, confusion, loss of appetite, constipation, tremor, drowsiness, neuroleptic malignant syndrome, adverse skin allergies, external bleeding, serious bone marrow damage, hepatitis, pancreatitis, seizures, tardive dyskinesia, and difficulty swallowing.

Warnings and Precautions:

For people taking MAO Inhibitors, the addition of buspirone may pose a health hazard. Reports of elevated blood pressure have occurred. It is therefore recommended that buspirone not be used with an MAOI. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of the depression or the emergence of suicidality in behavior and thought, or unusual changes in behavior, whether taking antidepressants or not. Antidepressants have been shown to increase the risk of suicidal thinking and behavior in short-term studies in children and teenagers with MDD and other psychiatric disorders. All pediatric patients being treated with antidepressants for any reason should be closely observed for clinical worsening, unusual changes in behavior, and suicidality, especially during the first few months of treatment, or with changes in dosage.

Withdrawal:

Venlafaxine is rather notorious for its potentially severe withdrawal symptoms upon sudden cessation (the recommended discontinuation is a decrease of 37.5mg/week; sudden discontinuation is recommended only in emergencies). These have a tendency to be significantly stronger than withdrawal effects of other antidepressants including tricyclics, but are similar to those of SSRIs such as Paxil. Withdrawal effects may include headache, nausea, fatigue, dysphoria, “brain shivers”, irritability, and hostility. Symptoms exhibited with more rarity include tremors, shaking legs, vertigo, paresthesia, and dizziness. Other symptoms can include impaired concentration, bizarre dreams, agitation and suicidal thoughts. Addictive effects are not indicated in withdrawal, but are rather the results of the brain attempting to reach neurochemical stability after an abrupt change. Such effects can be minimalized or avoided by tapering off of the medication over a period of weeks. Studies conducted by Wyeth-Ayerst Laboratories and others have reported occasional cases of withdrawal symptoms severe enough to require permanent use. In some of these instances, the medication was successfully discontinued eventually with the addition of fluoxetine, which was later itself discontinued without difficulty.

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