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Effexor treats depression in adults. Effexor XR extended-release treats depression, social anxiety disorder, panic disorder, and generalized anxiety disorder. The generic name of Effexor is venlafaxine. The medications are very similar. When Effexor is metabolized in the body, it turns into desvenlafaxine, the active ingredient of Pristiq.
The two drugs are similar but have some differences, such as in dose, price, side effect rates of occurrence, and drug interactions. Both drugs are similar in terms of efficacy. Your healthcare provider can guide you regarding which drug may be appropriate for you. Consult your healthcare provider for advice. He or she will weigh the benefits of taking an antidepressant vs. Neonates exposed to certain antidepressants, including SNRIs or SSRIs selective serotonin reuptake inhibitors like Prozac , in the third trimester of pregnancy, have developed serious complications.
Pristiq or Effexor should not be taken with alcohol because the combination may increase the risk of respiratory depression slowed breathing, not getting enough oxygen and increase sedation and drowsiness, and impair alertness.
The combination can also worsen anxiety and depression. Although Pristiq is only indicated to treat depression, some doctors prescribe it off-label for anxiety. Some people need to try different medications to see which works best. Consult your healthcare provider for more information. Drugs classified as mood stabilizers are usually used to treat bipolar disorder. Pristiq is indicated to treat depression. Taking Pristiq may make your mood feel more stable, but it is not classified as a mood stabilizer.
Effexor venlafaxine is an SNRI. Skip to main content Search for a topic or drug. Pristiq vs. Effexor: Differences, similarities, and which is better for you. By Karen Berger, Pharm. Updated on May. Want the best price on Pristiq?
Top Reads in Drug vs. The FDA approved recommended starting and maintenance dose for desvenlafaxine is 50 mg daily, while venlafaxine XR requires titration from The dose recommendation for desvenlafaxine is based on results from 8-week acute-phase clinical trials, but complete therapeutic response is not always achieved in this short time period.
Both venlafaxine XR and desvenlafaxine have limited clinically significant drug interactions. The most striking difference between the two products is cost. Venlafaxine and desvenlafaxine are essentially pharmacologically equivalent. Neither agent has significant affinity for cholinergic, alpha-adrenergic, or histaminergic receptors. A detailed comparison of adverse effects and tolerability among SNRIs was recently published by Alipour.
While there may be subtle variances in receptor binding affinity and adverse effects, more notable differences between the two medications are related to metabolism and FDA approved dosage. This article will review the data related to differences in metabolism and dosing between venlafaxine XR and desvenlafaxine to describe clinical significance.
In an attempt to quantify the effect of differences in metabolism between medications, the variances in medication metabolite plasma concentrations among CYP2D6 phenotypes have been measured.
Studies have examined the possibility of decreased venlafaxine tolerability and efficacy in PMs versus EMs. This finding may support the theory that CYP2D6 PM phenotype contributes to varied patient treatment response with venlafaxine; however, demographics as well as initial dosing and dosing titrations were not consistent between groups. Prospective randomized trials are needed to confirm this conclusion. Another retrospective review included German patients who experienced adverse effects or insufficient clinical response while taking CYP2D6 dependent antidepressants i.
Unlike venlafaxine, other antidepressants included in this review do not have pharmacologically equivalent active metabolites. Therefore, increased side effects are expected to occur in CYP2D6 PMs as the parent drug serum concentration accumulates. Results of this review cannot be generalized to venlafaxine as statistical significance cannot be determined for the small number patients who experienced side effects on venlafaxine.
Only one prospective study has demonstrated a statistically significant increased risk of side effects in PMs versus EMs taking a venlafaxine product. There does not appear to be a difference in severe side effects between the groups as the most commonly reported side effects were gastrointestinal side effects, and the difference in serum sodium concentrations does not appear to be clinically significant.
The HAM-D 17 remission rates and incidence of side effects did not differ between the two groups. Despite the inherent limitations of this pooled analysis of clinical trials using varying venlafaxine formulations and protocols, these results suggest that CYP2D6 PMs may respond less favorably to venlafaxine XR therapy than EMs.
Another potential difference between desvenlafaxine and venlafaxine XR is also related to metabolism: the risk for pharmacokinetic drug-drug interactions. Because desvenlafaxine has no significant effect on CYP2D6 at recommended doses, it is promoted as an appealing option to avoid potential drug-drug interactions with CYP2D6 substrates e.
In pharmacokinetic studies, venlafaxine IR The difference in FDA recommended dosing between venlafaxine XR and desvenlafaxine may make desvenlafaxine more appealing to some providers and patients. Despite pharmacokinetic similarities, clinical trial results are of primary importance when examining the safe and effective dosing range of desvenlafaxine.
During development, Wyeth Pharmaceuticals sought approval for up to desvenlafaxine mg daily, but the FDA selected 50 mg daily as the recommended dose. Medications only need to achieve statistical separation from placebo in primary outcome e. Response and remission rates are inconsistent among doses in these four short-term trials, and it's possible that there are clinically meaningful differences between 50 mg and higher daily dosages.
When desvenlafaxine 50 mg and mg daily were compared to placebo, the 50 mg dose had a remission rate significantly higher than placebo in only one of two studies. Current safety and efficacy data for the treatment of MDD suggest most patients are just as likely to tolerate and respond to venlafaxine XR as desvenlafaxine. For this reason, it is not advisable to add desvenlafaxine to a medication formulary.
For those who do take desvenlafaxine, longer term clinical trials comparing depression outcomes among desvenlafaxine 50 mg to mg doses are still needed to definitively determine the maximally effective dose and insure optimal treatment response.
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