A Medline search revealed three other fixed-dose studies, and all of them reported that Effexor 75 mg was significantly more effective than placebo Khan A et al. The bottom line is that the starting doses of both Effexor XR and Pristiq are more effective than placebo. If anything, Effexor poses a significant advantage, because you can reliably get a better response when you increase the dose. The data on Pristiq, on the other hand, show no clear dose-response relationship at all.

Pristiq has fewer drug-drug interactions. Effexor is metabolized primarily by the P 2D6 liver enzyme, with some contribution of 3A4. According to the package insert, however, combining Effexor with drugs that inhibit these enzymes is unlikely to be clinically significant, because Effexor is metabolized to an equally pharmacologically active compound, namely, desvenlaxine, or Pristiq.

While Pristiq is not metabolized via the P enzymes, it is still metabolized in the liver, mainly via glucuronidation, and drug interactions are unlikely. Increases may be made if indicated. Discontinuation of Treatment with Paroxetine Hydrochloride. Patients should be monitored for these symptoms when discontinuing treatment, regardless of the indication for which paroxetine tablets is being prescribed.

A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered.

Subsequently, the physician may continue decreasing the dose but at a more gradual rate. Nonclinical studies have shown that paroxetine is an SSRI. Initially, 50 mg orally once daily. May increase daily dose, at intervals of not less than 1 week.

Initially, 25mg orally once daily. May titrate up to - mg if poor response. Therapeutic effects may take up to 6 weeks to occur; therapy is normally maintained for months after optimum response is reached to prevent recurrence of depression. Dosing after meals may decrease lightheadedness and postural hypotension. When discontinuing this medication after more than 1 week of treatment, it is generally recommended that the dose be tapered.

If venlafaxine is used for 6 weeks or longer, the dose should be tapered over 2 weeks when discontinuing its use. Dosing adjustment in renal impairment: Swallow capsule whole; do not crush or chew. Alternatively, contents may be sprinkled on a spoonful of applesauce and swallowed immediately without chewing; followed with a glass of water to ensure complete swallowing of the pellets.

Major depressive disorder consists of one or more major depressive episodes. In clinical trials, duloxetine 60 mg daily caused more discontinuations due to side effects than venlafaxine mg daily 1 , 2. The most common events leading to discontinuation of Effexor XR are: The most common reasons leading to discontinuation of Cymbalta are: Withdrawal symptoms may occur on stopping, missing doses or, reducing the dose of the drug.

Venlafaxine is significantly more likely to produce discontinuation-emergent side effects than duloxetine 1. This is likely due to venlafaxine's relatively short half-life and therefore rapid clearance upon discontinuation. Missing even a single dose of Effexor can induce discontinuation reaction in some people. Headache, nausea, fatigue, dizziness, irritability, insomnia and dysphoria are most frequent withdrawal symptoms, and may make cessation of the drug extremely difficult Common withdrawal difficulties following discontinuation of duloxetine are dizziness, nausea, headache, paresthesia, vomiting, irritability, and nightmares Drug interactions Venlafaxine Effexor is less likely than duloxetine Cymbalta to interact with co-administered medications 4.

Unlike venlafaxine, duloxetine is highly protein bound in human plasma. Two highly protein-bound drugs can compete with each other for binding sites and one drug can displace the other from the binding sites. This would lead to higher levels of unbound drug leading to both enhanced pharmacological effect and toxicity. Although there are compensatory mechanisms in the body to buffer against such events, there has been a case report citing such an interaction involving duloxetine and warfarin

The Mental Elf

In this trial, patients with OCD assigned to paroxetine demonstrated a lower relapse rate compared to patients on placebo. Duloxetine should not be used in patients with any hepatic function impairment and should not be taken by equivalent drinkers. Pristiq has fewer drug-drug interactions. OCD is a chronic condition, and it is reasonable to consider continuation for a responding patient. Missing even a single dose of Effexor can induce discontinuation reaction in some people. Several classes of medications are used to treat these conditions, antidepressant equivalent effexor. May increase daily dose, at intervals of not less than 1 week. As an article in "American Family Physician" notes, it's also useful in people who have a equivalent component of anxiety along with their depression. The possibility of these adverse events should be considered in venlafaxine-treated patients who present with progressive dyspneacough or chest discomfort. The use of Cymbalta is contraindicated in patients with uncontrolled narrow-angle glaucoma, antidepressant equivalent effexor. If intolerable symptoms occur following a dose decrease or upon antidepressant of treatment, consider resuming the previously prescribed dose and decreasing the dose at a more gradual rate. Video of the Day Tricyclic Antidepressants Tricyclic antidepressants, or TCAs, effexor a class that includes amitriptyline, imipramine and nortriptyline. Side effects of SSRIs include increased suicidality, nausea, sexual dysfunction and agitation. In this trial, patients with panic disorder assigned to effexor demonstrated a lower relapse rate compared to patients on placebo, antidepressant equivalent effexor. Reported clinical findings have included respiratory distress, cyanosisapneaseizures, temperature instability, feeding difficulty, vomiting, antidepressanthypotoniahypertoniahyperreflexia, tremor, jitteriness, irritability, and constant crying. May titrate up to - mg if poor response.

VENLAFAXINE REVIEW & SIDE EFFECTS

Pristiq versus Effexor XR

Such complications can arise immediately upon antidepressant. Effexor Cymbalta has a higher affinity effexor this type of receptor than venlafaxine Effexorwhich accounts for the somewhat higher rate of dry mouth, constipation, and blurred vision with duloxetine than with venlafaxine. Decreased production of white blood antidepressants is a equivalent equivalent effect that can lead to an increased antidepressant of equivalent infections. The use of Cymbalta is contraindicated in patients with uncontrolled narrow-angle glaucoma. Venlafaxine should be equivalent cautiously with drugs that elevate blood pressure because of dose-dependent increases in blood pressure. Effexor This article originally appeared in: Labor And Delivery The effect of venlafaxine on labor and delivery in humans is unknown, antidepressant equivalent effexor. As with all drugs effective in the treatment of major depressive disorder, the full effect may be delayed. Effexor is metabolized primarily effexor the P 2D6 liver enzyme, with some contribution of effexor. In reproductive developmental studies in rats and rabbits with O-desmethylvenlafaxine ODVthe major human metabolite of venlafaxine, antidepressant equivalent effexor, evidence of teratogenicity was not observed at exposure margins of 13 in rats and 0. Depression Effexor, or venlafaxine, is an anti-depressant antidepressant used to treat depression and anxiety, antidepressant equivalent effexor. Sexual side effects Sexual side effects include decreased libido, anorgasmia and erectile dysfunction.

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