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Effexor FAQ Version 1.0 3 March 1994
Index.
1. What is Effexor
2. How does Effexor differ from other antidepressants?
3. What kinds of depression can be treated with Effexor?
4. What are the side-effects of Effexor?
5. Which side effects force people to stop taking Effexor?
6. Are there any special hazards for people with bipolar disorder?
7. Does Effexor interact with other medications?
8. Does Effexor interact with alcohol?
9 Is Effexor safe for a woman who is pregnant, about to become pregnant,
or nursing an infant?
10. How is treatment with Effexor initiated?
11. What is the usual final dose of Effexor?
12. Are there withdrawal effects if Effexor is suddenly discontinued?
13. Is Effexor toxic if an overdose is taken?
14. What will Effexor cost?
15. When will Effexor be available?
16. Additions and corrections.
===========================================================================
1. What is Effexor
Effexor is a new antidepressant with a novel chemical structure. The
chemical structure of Effexor does not resemble those of any currently used
antidepressants. Effexor is not an MAO inhibitor
2. How does Effexor differ from other antidepressants?
Effexor seems to have the relative freedom from side-effects
associated with the SSRIs [fluoxetine (Prozac), sertraline (Zoloft),
paroxetine (Paxil), fluvoxamine (Luvox)] and the impact on both the serotonin
and norepinephrine associated with the tricyclic antidepressants
(amitriptyline (Elavil), inipramine (Tofranil) etc.). It is hypothesized
that the action of the Effexor molecule upon both serotonin and
norepinephrine will cause Effexor to be a successful antidepressant for some
people who have not responded to treatment with SSRIs.
3. What kinds of depression can be treated with Effexor?
While the pre-marketing studies were restricted to patients with a
DSM-III-R diagnosis of Major Depressive Disorder (with or without
melancholia), it is to be expected that Effexor will be prescribed for
patients with Dysthymia, Major Depression, and Bipolar Disorder.
Although here have been no published studies on the use of Effexor
for the treatment of children and adolescents with depression, it can be
expected that the drug will be prescribed for depressed children and
adolescents.
No special problems were encountered when Effexor was prescribed for
elderly people with depression.
While Effexor was only studied for periods of administration of
up to 6-weeks, it is to expected that patients with long-standing
depressions will take the drug for longer periods of time.
4. What are the side-effects of Effexor?
The most common side-effects and the percentage of people reporting
them during clinical trials are:
Nausea 37%
Headache 25%
Sleepiness 23%
Dry mouth 22%
Dizziness 19%
Insomnia 18%
Constipation 15%
Nervousness 13%
Fatigue 12%
Sweating 12%
Decreased appetite 11%
Male sexual dysfunction 12%
Female sexual
Dysfunction 2%
5. Which side effects force people to stop taking Effexor?
In the premarketing studies 19% (537 / 2897) of depressed
patients taking Effexor discontinued the medication because of side-effects.
The side effects and the percentages of total patients who dropped out for
each are:
Nausea 6%
Sleepiness 3%
Insomnia 3%
Dizziness 3%
Male sexual dysfunction 3% *
Headache 2%
Nervousness 2%
Anxiety 2%
Dry mouth 2%
Fatigue 2%
Sweating 2%
* % of men
6. Are there any special hazards for people with bipolar disorder?
As with other antidepressants, people with bipolar disorder who are
not being treated with a mood regulator such as lithium, valproate
(Depakote), or carbamazepine (Tegretol), may be pushed into a manic episode
when treated with Effexor.
7. Does Effexor interact with other medications?
Lithium - No interaction
Diazepam (Valium) - No interaction
Cimetidine (Tagamet) - Slight increase in blood level of
Effexor's active metabolite. Not of clinical significance.
Fluoxetine (Prozac) - Significant increase in the concentration
of Effexor and its active metabolite. Potential for increased side-
effects.
8. Does Effexor interact with alcohol?
Although Effexor has not been found to increase the impairment of
cognitive or motor skills caused by alcohol, the manufacturer warns against
drinking while taking Effexor.
9 Is Effexor safe for a woman who is pregnant, about to become pregnant,
or nursing an infant?
There is no data to establish the safety of Effexor for the fetus
or nursing infant.
9. How is treatment with Effexor initiated?
The usual starting dose of Effexor is 75 mg a day taken in two or
three divided doses with food (to minimize nausea). If higher doses are
needed, the dose should not be increased more rapidly than 75 mg every 4
days.
10. What is the usual final dose of Effexor?
While doses up to 375 mg per day are approved by the FDA, some
severely depressed patients have been treated with higher doses. Most
depressed people have been found to respond to doses under 300 mg per day.
11. Are there withdrawal effects if Effexor is suddenly discontinued?
Effexor should be discontinued gradually over at least 2-weeks. If
Effexor suddenly discontinued, a withdrawal syndrome involving fatigue,
nausea, dizziness, headache, insomnia, and nervousness, may develop.
12. Is Effexor toxic if an overdose is taken?
Fourteen overdoses of Effexor have been reported. In some cases
Effexor was taken along with alcohol and/or other medications. All
individuals who took an overdose recovered without sequelae.
13. What will Effexor cost?
Effexor will be supplied in tablets ranging from 25 to 100 mg in
strength. The 25 mg tablets cost pharmacies nearly as much as the 100 mg
tablets. It is expected that all strengths of Effexor will be sold for
between $1.00 and $1.50 per tablet.
14. When will Effexor be available?
A few psychiatrists have been given small supplies of Effexor.
It is expected that Effexor will be widely available by the first week of
April of 1994.
15. Additions and corrections.
This FAQ was prepared by Ivan K. Goldberg, MD. Please address
comments and/or questions regarding this FAQ to: IKG@mindvox.phantom.com.
--
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