Venlafaxine

George Papakostas

A. General information

· Contraindicated in patients with a seizure disorder, history of anorexia nervosa or history of bulimia.

· Contraindicated in patients on MAOI inhibitors.

· If a patient has been on Effexor for more than one week, a slow

taper is recommended to avoid withdrawal symptoms.

· Dosing:

· For XR max daily dose: 225 qd

· For IR max daily dose: 375 mg (divide BID)

B. B. Metabolism

· Hepatically metabolized

· Must adjust for GFR and hepatic function

C. Side Effects.

· CNS: insomnia, nervousness, seizure (0.3%)

· Endocrinologic: Weight loss>5% body weight that is in some studies (7% of pt’s vs 2% of placebo patients in one study).

· Gastrointestinal: Nausea, anorexia, dry mouth

· CV: palpitations, elevaton of BP .