Venlafaxine

Venlafaxine — brand names: Effexor, Effexor XR, Lanvexin, Viepax and Trevilor — is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. This means it increases the concentrations of the neurotransmitters serotonin and norepinephrine in the body and the brain. First introduced by Wyeth in 1993, now marketed by Pfizer, it is licensed for the treatment of major depressive disorder (MDD), generalised anxiety disorder (GAD), panic disorder and social phobia.

"Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis" has shown venlafaxine, alongside mirtazapine, escitalopram and sertraline was significantly more efficacious. Remission rates (defined as a HAM-D score of 7 or less) were 58% for venlafaxine plus mirtazapine. This combination is known by the medical slang term "California rocket fuel".

The rate of life-threatening or lethal outcomes for suicidal overdoses of venlafaxine is lower than for the TCAs, MAOIs and bupropion and comparable to several of the SSRIs. It is metabolised in the body into another antidepressant drug called desvenlafaxine (O-desmethylvenlafaxine) which is also sold as an antidepressant, under the brand name Pristiq.