What is Venlafaxine (Effexor)? Venlafaxine is a medication that is used to treat depression and anxiety. It is sold under the brand name Effexor. Although not considered chemically addictive, it can cause psychological addiction and abuse. When users stop taking such antidepressants, they are likely to experience Effexor withdrawal symptoms or antidepressant discontinuation syndrome. That is why it is essential to know everything about treatment with this medication and how to wean off the drug successfully.
So, what is Venlafaxine used for? How does the addiction develop? What are the discontinuation symptoms? Read on to find answers.
What Is Venlafaxine?
Venlafaxine is a prescription medication. It was approved by the US Food and Drug Administration (FDA) in 1993. It was first developed by Wyeth Pharmaceuticals Inc., which was eventually bought by Pfizer. Except for the common use of Effexor for anxiety and major depressive disorder, it can also be used for generalized anxiety disorder, panic disorder, and social anxiety disorder.
Although it has been available on the US market and approved for treating depression since 1993, the US Food & Drug Administration (FDA) issued a warning about the potential for congenital disabilities. Taking Effexor during pregnancy may increase the risk of having a baby born with defects and have an increased chance of a miscarriage.
Venlafaxine Drug Class
Venlafaxine drug class belongs to a group of antidepressants called SNRI (selective serotonin and norepinephrine reuptake inhibitor). It works by potentiating norepinephrine and serotonin in the central nervous system through inhibition of their reuptake. Increasing serotonin and norepinephrine in the brain can improve symptoms of depression and anxiety.
The effects appear after about two weeks of its administrators. So, don’t stop using the medication even if no results are felt at the beginning of the treatment. Stopping the use without a doctor’s consultation may worsen the health condition.
What Is Venlafaxine Used for?
The drug has numerous uses, many of them related to anxiety and depression. There are also some off-label uses for which doctors prescribe Effexor. Doctors will examine and ask about a patient’s wellbeing to competently diagnose any of the following conditions for which the drug can be prescribed.
Effexor is Used For:
- Anxiety. This includes the treatment of generalized anxiety disorder (GAD) and social anxiety disorder (SAD).
- Depression. Venlafaxine increases the amount of serotonin – a chemical in one’s body that brings about happiness and general wellbeing. According to the American Psychiatric Association, depression is a major condition that affects all aspects of a person’s daily life. The affliction can show up as generalized depressive disorder or major depressive disorder.
- Panic Attacks. Imbalance in the amounts of neurotransmitters serotonin and norepinephrine causes various anxiety disorders, including panic disorder. Since venlafaxine ER has anxiolytic properties, doctors use it to manage panic disorder in patients.
- Attention deficit hyperactivity disorder (ADHD). ADHD is a condition that entails uncontrolled behavior, difficulty paying attention, and general overactivity. According to data from the National Comorbidity Survey, the lifetime prevalence of the disorder in adolescents alone is 8.7 percent. With this relatively big number, the use of Effexor for ADHD treatment is widespread.
- Bipolar Disorder. Medical professionals also use the medication for bipolar disorder treatment and management. This is a condition where the patient swings between extremes of moods. By balancing the serotonin and norepinephrine amounts, Venlafaxine can help those with bipolar disorder to control the symptoms.
- Obsessive-compulsive disorder (OCD). A study published in The Journal of Clinical Psychiatry showed that patients who had found no reprieve from the condition with selective serotonin reuptake inhibitors (SSRI) showed some positive signs when doctors use Effexor for OCD treatment.
- Post-traumatic stress disorder (PTSD). Effexor is an effective treatment for PTSD because it’s a serotonin and norepinephrine reuptake inhibitor (SNRI).
As more research was carried out into Venlafaxine, it was discovered that it had other benefits. Doctors prescribe the medication for other off-label uses. For example, towards the end of a woman’s reproductive cycle, doctors may prescribe Venlafaxine for hot flashes. Doctors also administer Effexor for migraines because some studies have shown that it effectively provides relief and well-tolerated.
Although it’s not sanctioned to treat pain, doctors may use Effexor for pain management. The most common kinds of pain where the drug’s use is widespread include neuropathic pain and fibromyalgia.
Is Effexor Addictive?
Effexor is not physiologically addictive, but psychological addiction is possible. Effexor addiction occurs when a person misuses or combines it with other medications to get high. Persons with anxiety or depression may abuse it to try to elevate mood by increasing the dose. Some teenagers may also try to get the drug illegally to get high effects. Effexor abuse may also appear after taking the medication in larger or more frequent doses without doctor consultation. In this case, withdrawal from Effexor can be more challenging and uncomfortable.
Effexor Abuse Statistics
Only very little data on venlafaxine abuse in the US is available. A study published in the US National Library of Medicine reported a case of a 38-year-old male with a history of depression and amphetamine dependence who misused Venlafaxine by crushing tablets and by inhalation to manage severe depression, taking up to 1,500 mg per day. The same study also described a case of a 53-year-old male who used up to 3,750 mg at a time to feel “more empathic and sociable” and “elated” mood.
Analysis of European data with 47,516 people prescribed Venlafaxine found that just over 200 people (0.45%) met the abuse criteria. The largest problem with the medication is venlafaxine withdrawal symptoms associated with antidepressant discontinuation syndrome (ADS).
Prolonged medication intake alters the brain’s chemical process, so when the brain is not getting enough of venlafaxine capsules or tablets, it can misfire, manifesting as various symptoms. The effects of withdrawal from Effexor tend to happen when there is a low quantity of Venlafaxine or its active metabolite in the blood. Missing a dose may cause a wide array of physical and psychological symptoms, which can be very discomforting to the patient. The side effects of stopping can vary a lot in severity.
In fact, in one clinical presentation, the symptoms were so intense that it looked like a stroke.
However, in most cases, Effexor withdrawal manifests as physical and psychological symptoms.
According to the Food and Drug Administration (FDA) Data, The Physical Effexor Withdrawal Symptoms List Includes the Following:
- Muscle pain
- Nausea or vomiting
- General malaise
- Excessive sweating
- Abdominal discomfort
- Feeling restless
- Lethargy and weakness
- Persistent dizziness
- Dry mouth
- Muscle twitches
- Gait disturbances
- Hot flashes
- Persistent sound in the ears
As a result of these symptoms, going through a complete withdrawal from Effexor without proper care can be a difficult task, even for someone on the lowest dose. The symptoms are not just uncomfortable but can also be disabling. Unfortunately, they can last for several weeks.
Apart from the physical symptoms, people who omitted some dose of Venlafaxine or suddenly stopped taking it entirely also complain of having psychological symptoms. The symptoms seem to be more severe in those who’ve had too much before discontinuing it.
The Psychological Venlafaxine Withdrawal Symptom List Includes the Following:
- Poor concentration ability
- Too many dreams and nightmares
- A lack of inhibition or self-control
- Aggression Irritability
- Dysphoric mood
- Mood swings
- Worsening depression
- Mental confusion
- Blurred vision
- Visual and auditory hallucinations
- Tingly sensations
- Crying spells
- Features of psychosis
- Panic attacks
In some people, not taking Venlafaxine as and when due can make them experience some electrical sensations in their head ‒ a phenomenon called Effexor brain zaps. Although it usually affects the head region, it may get to other areas within the body. Brain zaps may be triggered by some action like eyes moving and come together with ringing in the ears and the feeling of disorientation.
Effexor withdrawal symptoms like brain zaps should be managed by particular medications. Some patients may also have anorexia or suicidal thoughts.
How Long Does Effexor Withdrawal Last?
The duration of withdrawal can be quite different from person to person, but the effects can last for about a week or more for most people. That is why venlafaxine dose is usually weaned off for a few weeks. However, in some cases, withdrawal symptoms can last up to a month or more. Since the half-life of Venlafaxine is about four hours, Effexor withdrawal symptoms typically start from around 5 to 12 hours after skipping a venlafaxine dose or stopping the drug entirely.
Generally, The Timeline for the Symptoms Is As Follows:
- Day 1-3: The patient begins to experience the manifestations of the symptoms, which may be gradual or sudden in onset.
- Day 4-6: The symptoms become more intense, and the patient may find them discomforting and disabling.
- Week 1-3: The symptoms may have subsided in some people, but in some others, they may persist.
- Week 4 and beyond: For most people, the symptoms must have stopped. Whatever may be happening at this period may be a relapse of the condition which Venlafaxine was used to treat. It is only in a few people that the symptoms may persist beyond this time.
Factors That Influence The Withdrawal Timeline
One factor that may determine how long Effexor withdrawal can last is the duration of treatment. All other things being equal, someone who has been on Venlafaxine for months or years would experience venlafaxine withdrawal effects longer than a person who took it for a few weeks. However, any patient on the medication for up to one week has a high chance of experiencing the symptoms. This is true even for venlafaxine withdrawal after recreational use. For instance, after mixing Effexor and Adderall to get euphoric feelings, the withdrawal symptoms would continue for a more extended period. They would require a complete detox program because of their high severity.
It is highly recommended not to use Effexor for recreational purposes alone or in combination, as it may cause significant harm to health and lead to legal liability.
Another factor that can affect Effexor withdrawal symptoms duration is the dosage. Apart from the possibility of experiencing venlafaxine weight gain, people who are on higher doses of Venlafaxine are more likely to have the symptoms over a longer duration when they discontinue the medication.
Furthermore, taking other medications or psychoactive substances with Venlafaxine can worsen the symptoms. For instance, people who take alcohol and Effexor would likely suffer from withdrawal symptoms over a more extended period. Other factors like genetics, metabolic rate, and other medical and mental health conditions can also influence how an individual would feel the withdrawal from Effexor.
Weaning Off Effexor: How To Stop Taking It
As highlighted, stopping Venlafaxine can cause some undesirable side effects. Tapering off Effexor is, therefore, the recommended course of action instead of stopping suddenly.
Successfully stopping Venlafaxine will depend on the dosages that the patient has been taking. Doctors also consider any health incidents that occurred during the last time the patient was weaning off Venlafaxine. According to an article in Harvard Health, Effexor tapering usually occurs in 4 stages of decreasing doses. There is no set time interval until the next interval because it depends on how the individual responds to the dosage.
Typically, one the first dose reduction would be from 300 mg of Venlafaxine to 225 mg. It would then be reduced further to 150 mg after a period that the doctor considers suitable. The final reduction would be to 37.5 mg after coming off venlafaxine 75 mg.
Generally, doctors will ask if there are any side effects of coming off the substance and adjust the dosage accordingly. For this reason, some people might take just a few weeks to get off the Venlafaxine, whereas others might take longer to do so. Professional doctors are knowledgeable about how to taper off Effexor. Patients should, therefore, consult the doctors before undertaking this process without proper medical knowledge. Without this knowledge, there is a risk of causing significant harm to health.
Switching From Venlafaxine To Other Antidepressants
Occasionally, some situations require switching from one antidepressant to another. It requires a detailed comparison of the similar drugs, for example Pristiq vs. Effexor. It could be that the initial drug did not work well, and the doctor wants to try the patient on another one. Other times, the initial drug might have serious side effects compared to the second one. Nevertheless, there comes a time when it is necessary to change from one antidepressant to another. It is, therefore, possible to switch from Venlafaxine to another antidepressant medication.
According to a paper, doctors generally carry out a conservative switch when it comes to changing antidepressants. The patient weans off the first medication over four weeks and is drug-free for a time equivalent to 5 half-lives of the antidepressant. The doctors then prescribe the recommended dosage of the new medication.
A moderate switch entails weaning off the patient from the first antidepressant and then allowing a washout period of 2 to 4 days. The new antidepressant is then started at a low dosage. These two modes of switching are advantageous because they reduce the risk of drug interactions.
However, there is also a direct switch where one medication is stopped, and the other started the following day. Although it is quick and simple, there is a high risk of drug interactions. It is, therefore, vital that switching between medications is done only under the recommendation and supervision of a doctor.
How To Stop Taking Effexor Safely
When it comes to stopping medication use safely, patients need to be under the doctor’s guidance. This is because medical personnel have the proper knowledge of how to wean off Effexor.
Going off Effexor cold turkey is not advisable because it leads to some harmful side effects. Therefore, patients should use the tapering method that involves weaning off the Venlafaxine to switch to another drug or stop taking drugs. During this time, patients should discontinue Effexor and alcohol consumption because it can compromise the safety of stopping the medication.
Patients should not attempt to stop taking Venlafaxine without consulting professional doctors who have experience in substance abuse prevention and treatment and managing discontinuation syndrome. Because stopping can be a complicated process, some patients will need to check into a drug rehabilitation facility to get effective care.
Frequently Asked Questions
Is Effexor an SSRI?
Effexor is not an SSRI(selective serotonin reuptake inhibitor), just as Venlafaxine does not belong to an SSRI class. SNRI drug type has a more general effect on the brain, affecting both norepinephrine and serotonin metabolism, while SSRI class only affects serotonin. This is the main difference between Effexor and Lexapro, while both medications treat depression.
Is Effexor a Controlled Substance?
According to the legal substance classification, Effexor is not on the list of controlled substances. These substances are often scheduled and rigorously controlled, whereas no schedule level has been assigned to a venlafaxine class of medications.
Is Effexor a Stimulant?
Venlafaxine is not a stimulant. Stimulants medication type also affects serotonin, norepinephrine, dopamine, and other neurotransmitters, but these medications also increase the activity of the sympathetic nervous system, which isn’t the effect SNRI class of drugs produce
Is Effexor an MAOI?
Effexor drug does not belong to an MAOI class of medications. Monoamine oxidase inhibitors are the first generation of antidepressants. While venlafaxine drug class affects the reuptake of norepinephrine and serotonin, MAOIs prevent the breakdown of these and other neurotransmitters, prolonging their stay in the synaptic cleft.
Is Effexor a Narcotic?
Effexor does not belong to narcotic medications. Narcotics and venlafaxine drug class have a different use, chemistry, and mechanisms of action. Narcotics are used primarily for treating pain, while venlafaxine class is used to treat psychological problems, although some doctors prescribe it to patients with diabetic neuropathy and migraine.
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