Doctors' Answers to "Frequently Asked Questions" - Effexor

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Effexor [posted 1/13/99]
Question: Could I have some information on Effexor?

Answer: Effexor is an antidepressant in a class of its own. Its mechanism is currently unknown, but thought to work through Serotonin receptors in some way. Side effects include nausea, headache, somnolence and constipation.

Effexor [posted 1/11/99]
Question: Regarding the gentleman's question regarding just starting Effexor after Prozac stopped working, I had a similar experience with Prozac as well. It worked at first with the depression, but after a couple of years it stopped working for me. For another year afterwards I was placed on other various anti-depressants with little results. Finally I gave up with my psychiatrist and started using St. John's Wort on my own. It helped somewhat, but the depression came back for longer and longer periods and I was getting desperate. So it was back to another doctor, who promptly put me on Effexor XR 75 mg. My experience over the past 3 months on this medication has been wonderful. Unlike Prozac, I have far less fatigue and feel more "normal" on this medication. I'm also less anxious. My only concern is that this medication may also stop working somewhere down the line, but it buys me time until perhaps someday, there will be a cure for this terrible disease. So to the gentleman who just started using it, I would say hang in there and give this medication a chance. It works. Life feels good again.

Answer: Well, we really don't know the real mechanism of depression. When we do we can give both of you a better answer. Thanks for your input.

After effects of Effexor [posted 1/8/99]
Question: What are the "after effects" when one stops taking effexor?

Answer: Different patients report different problems. Some none, some a 2-3 week feeling of headaches, muscle pain, fatigue, etc.

Getting off Effexor [posted 1/8/99]
Question: I have gained about 50 pounds in the last 18 months while taking Zoloft first, then Effexor to treat depression. I am trying to get off the medications entirely, but it is very difficult because of the dizziness and disorientation I suffer when I reduce the dosage or quit all together. I am also very concerned about having gained so much weight. What is the preferred method of getting off Effexor to minimize the symptoms I described? When I quit taking Effexor, will I loose the weight that I have gained?

Answer: Usually, if you can stop. Some patients have less trouble with weight on St. John's Wort. Although it is somewhat less effective in treating depression it generally has less weight, sexual side effects.

Effexor & Anesthesia [posted 12/02/98]
Question: Is there any research on problems with a person on effexor receiving general anesthesia? Thank you.

Answer: I don't have specifics;but, I'd check with the manufacturer Wyeth-Ayerst 800-934-5556.

Effexor & Prozac [posted 10/29/98]
Question: I took prozac for a little over three weeks with no improvement. The doctor switched me over to a low dose of effexor, 37.5. So I stopped prozac one day and started the effexor the next. I wasn't expecting to notice any change right away, but to my surprise, I noticed a big change within just a few hours after taking the effexor; however, this did not last. It became less and less each day until there was no positive effect at all after the fifth day. I feel that a combination of the two drugs really worked for me since I clearly still had some prozac in my system, but my doctor seemed to think that I just needed a higher dosage of effexor. I am taking 75 now, but it still does not work as well as it first did when I came off the prozac. Can you offer any advise? My doctor has also mentioned wellbutrin.

Answer: A combination using small doses of prozac seems to be the answer. No contraindication that I am aware of.

General Info on Effexor [posted 10/16/98]
Question: Can someone please tell me more about Effexor? Any help would be appreciated.

Answer: Effexor is a relatively new antidepressant. Its mode of action is unknown;but, appears related to sertotonin. It is not in the same class as Prozac(Serotonin Reuptake Inhibitors). It should be started at small doses and gradually increased until effective. It usually takes 10 days to 2 weeks for a change in dosage to have any appreciable effect. Side effects include drowsiness, nausea, dry mouth and decreased sex drive.

Chronic Back Pain and Effexor [posted 8/11/98]
Question: My doctor recently gave me Effexor for back pain. Is this normal? I've read a lot of information about this drug on the internet, none of it too good. Also I take Restoril at night and Hydrocodone. Is it all right to take these medications?

Answer: Effexor is an antidepressant which is in a class of its own. Many physicians employ antidepressants in the treatment of pain (especially chronic) since the antidepressants tend to work in the same type of nerve fiber as responsible for pain. There should not be any problem mixing Effexor and Restoril unless the doses are increased. However, occasional patients will have excessive drowsiness during the day.

Effexor and Depression [posted 8/6/98]
Question: I have suffered from depression since I was a child. (I am now 56 years old) and have tried every avenue of help. I have been prescribed Paxil, Prozac, and over the years, many anti-depressants. I have tried herbal remedies, over the counter herbs, etc. Although I have been to many professional doctors, counselors, Alanon programs, etc., my depression still lingers on - sometimes less and sometimes more. I am really tiring of constantly battling this problem. I have recently been given Effexor. My doctor (pysch) feels that my problem stems from a chemical imbalance, of which I totally agree to. I would like to read of the pros and cons of Effexor.

Answer: Effexor is an antidepressant in a class of its own. The mode of action is not clear. Side effects include: somnolence, insomnia, vertigo, dry mouth, constipation, headache, decreased appetite, sweating, anxiety and blurred vision. This medication seems to work where others have not. Patients generally have marked side effects or almost none.

Effexor [posted 8/4/98]
Question: I am taking effexor for depression and I just stopped taking fluoxetine approximately 2 weeks ago. I was on it for approximately 3 years with great initial success, but it just stopped working for me. Is effexor close in chemistry to fluoxetine? Also, I am reading some good things, but also some horror stories, such as significant weight gain and withdrawal. I am just looking for some facts so when I go see my physician next week, I will be a little prepared to speak with him regarding pros and cons of effexor therapy.

Answer: Effexor is a complete class of its own unrelated to other antidepressants. As to side effects, they tend to be very individual. Some patients lose weight, some gain weight. Withdrawal is a little more than the SRI class of antidepressants in general, but is not severe. Generally, it is a little less tolerated than the SRI, but is an effective medication.

Sexual Dysfunction Side Effects with Effexor [posted 8/4/98]
Question: This medication, Effexor XR, works wonderfully and I am aware personally and through the literature and studies that this is a common problem in males. Is there a remedy or way to minimize or better yet, eliminate these side effects? It is impacting me emotionally and maritally. If there is no remedy (I've yet to hear of one, other than Gynko and hybocine, which are not FDA approved), what might you suggest. Tapered dosages do not help either. Are there any new studies under way to further explore this frustrating and life-impacting side effect?

Answer: Two possibilities. There is one research article that cites using small doses of amphetamines to restore sexual drive when using SRI antidepressants. Effexor isn't a SRI (a complete class of its own), but this might be worth a try. Second, Serzone is one of the better drugs in this class to decrease this problem - worth a try.

Effexor Cardiorespiratory Problems [posted 7/17/98]
Question: I am in the process of coming off Effexor from 200 mg a day down to 105.7 mg. Is there any relation to cardiorespiratory problems and coming off Effexor?

Answer: No.

Effexor
Question: Can Effexor cause the pupils to stay dilated all the time?

Answer: It has a slight anti-cholinergic effect and will dilate the pupils slightly.

Side effect
Question: I have been taking Effexor for about 6 weeks. It's working well, but I have been constipated ever since I started taking it. Will this last as long as I'm taking the drug (150 mg/day) and/or should I ask my physician for a different medication?

Answer: It will last as long as you take it. If it works well, I'd address the constipation with milk of magnesia, stool softeners, and dietary fiber. The other medications similar to this drug will also tend to cause constipation.

Effexor and Depakote
Question: I am a bipolar who is currently taking Effexor and Depakote. Should I avoid prolonged exposure to sunshine and generally hot summertime conditions? That is, more so than a person who is not on these medications?

Answer: Depakote has been implicated in causing discoid lupus. This would involve sun sensitivity. Otherwise neither is a big risk.

Effexor
Question: What are the long term effects of effexor?

Answer: Hard to know since it's only been used a couple of years. So far nothing dramatic. This is based on original studies with follow up and European data.



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