Venlafaxine
Venlafaxine, sold under the brand name Effexor among others, is an antidepressant medication of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is used to treat major depressive disorder, generalized anxiety disorder, panic disorder, and social anxiety disorder. Studies have shown that Venlafaxine improves quality of life. It may also be used for chronic pain. It is taken by mouth. It is also available as the salt venlafaxine besylate in an extended-release formulation (Venbysi XR).
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| Pronunciation | /ˌvɛnləˈfæksiːn/ VEN-lə-FAK-seen |
| Trade names | Effexor, Efexor, Venbysi XR, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a694020 |
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| Routes of administration | By mouth |
| Drug class | Serotonin–norepinephrine reuptake inhibitor |
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| Bioavailability | 42±15% |
| Protein binding | 27±2% (parent compound), 30±12% (active metabolite, desvenlafaxine) |
| Metabolism | Extensively metabolised by the liver, primarily via CYP2D6 |
| Metabolites | O-desmethylvenlafaxine (ODV), see desvenlafaxine |
| Elimination half-life | 5±2 h (parent compound for immediate release preparations), 15±6 h (parent compound for extended release preparations), 11±2 h (active metabolite) |
| Excretion | Kidney (87%; 5% as unchanged drug; 29% as desvenlafaxine and 53% as other metabolites) |
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| ECHA InfoCard | 100.122.418 |
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| Formula | C17H27NO2 |
| Molar mass | 277.408 g·mol−1 |
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| Chirality | Racemic mixture |
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Common side effects include loss of appetite, constipation, dry mouth, dizziness, sweating, insomnia, drowsiness and sexual problems. Severe side effects include an increased risk of suicide, mania, and serotonin syndrome. Antidepressant withdrawal syndrome may occur if stopped. There are concerns that use during the later part of pregnancy can harm the baby. How it works is not entirely clear, but it seems to be related to the potentiation of the activity of some neurotransmitters in the brain.
Venlafaxine was approved for medical use in the United States in 1993. It is available as a generic medication. In 2021, it was the 44th most commonly prescribed medication in the United States with more than 15 million prescriptions.