Venlafaxine - Revision history

MDElliottMD: home-claude: fix CPIC citation hard errors (CPIC scope does not cover these medicines; correct to PharmGKB/DPWG/FDA label where applicable)

2026-05-27T02:23:03Z

home-claude: fix CPIC citation hard errors (CPIC scope does not cover these medicines; correct to PharmGKB/DPWG/FDA label where applicable)

← Older revision		Revision as of 02:23, 27 May 2026
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	\| pregnancy = Observational signal for neonatal adaptation syndrome with late-pregnancy exposure; weigh against the risks of untreated maternal depression.{{citation needed}}		\| pregnancy = Observational signal for neonatal adaptation syndrome with late-pregnancy exposure; weigh against the risks of untreated maternal depression.{{citation needed}}
	\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="effexor-xr-label" />		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="effexor-xr-label" />
	\| mechanism = <vote slug="venlafaxine-mech-claim">Serotonin and norepinephrine reuptake inhibitor with predominantly serotonergic activity at lower doses (37.5-150 mg); the noradrenergic effect adds at higher doses (>150 mg) and the dual-mechanism advantage really emerges then. The active metabolite desvenlafaxine (separately marketed as Pristiq) contributes meaningfully to clinical effect.</vote> '''Severe discontinuation syndrome''' is the marquee adverse-effect feature: venlafaxine's short half-life produces intense flu-like symptoms, dizziness, electric-shock sensations ("brain zaps"), and emotional dysregulation on abrupt discontinuation, worse than most other SNRIs and SSRIs. Slow taper essential. Dose-dependent '''diastolic hypertension''' at higher doses; routine BP monitoring at dose escalation. CYP2D6 substrate; ~~CPIC PGx guidance applies~~<ref name="~~cpic~~-~~snri~~">~~CPIC Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors, 2023~~. https://~~cpicpgx~~.org/~~guidelines/guideline-for-selective-serotonin-reuptake-inhibitors-and-cyp2d6-and-cyp2c19~~/</ref>.		\| mechanism = <vote slug="venlafaxine-mech-claim">Serotonin and norepinephrine reuptake inhibitor with predominantly serotonergic activity at lower doses (37.5-150 mg); the noradrenergic effect adds at higher doses (>150 mg) and the dual-mechanism advantage really emerges then. The active metabolite desvenlafaxine (separately marketed as Pristiq) contributes meaningfully to clinical effect.</vote> '''Severe discontinuation syndrome''' is the marquee adverse-effect feature: venlafaxine's short half-life produces intense flu-like symptoms, dizziness, electric-shock sensations ("brain zaps"), and emotional dysregulation on abrupt discontinuation, worse than most other SNRIs and SSRIs. Slow taper essential. Dose-dependent '''diastolic hypertension''' at higher doses; routine BP monitoring at dose escalation. CYP2D6 substrate; CYP2D6 oxidation produces the active metabolite desvenlafaxine. PharmGKB clinical annotations for venlafaxine apply (Level 2A).<ref name="pharmgkb-venlafaxine">PharmGKB: Venlafaxine pharmacogenomics annotations. https://www.pharmgkb.org/chemical/PA451866</ref> No formal CPIC guideline covers venlafaxine; the CPIC SSRI/CYP2D6 guideline (Hicks 2015) covers sertraline, citalopram, escitalopram, fluoxetine, fluvoxamine, and paroxetine and does not extend to SNRIs.
	}}		}}

MDElliottMD: parser-claude: Venlafaxine MedTemplate refill, Top 300 stub upgrade

2026-05-23T06:39:03Z

parser-claude: Venlafaxine MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 06:39, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Venlafaxine		\| generic = Venlafaxine
	\| brand = Effexor		\| brand = Effexor XR, Effexor IR (discontinued in US, generic widely available)
	\| structure =		\| structure =
	\| classes = SNRI, Antidepressant		\| classes = [[:Category:SNRIs\|Serotonin-norepinephrine reuptake inhibitor (SNRI)]], [[:Category:Antidepressants\|Antidepressant]], [[:Category:Anxiolytics\|Anxiolytic]]
	\| ~~mechanism = Serotonin–norepinephrine reuptake inhibitor~~		\| uses = <vote slug="major-depressive-disorder-use">Major depressive disorder (FDA)</vote>, <vote slug="generalized-anxiety-disorder-use">Generalized anxiety disorder (FDA)</vote>, <vote slug="social-anxiety-disorder-use">Social anxiety disorder (FDA)</vote>, <vote slug="panic-disorder-use">Panic disorder (FDA)</vote>, <vote slug="ptsd-use">Posttraumatic stress disorder (off-label)</vote>, <vote slug="neuropathic-pain-broad-use">Neuropathic pain (off-label)</vote>, <vote slug="menopausal-vasomotor-use">Menopausal vasomotor symptoms (off-label, evidence-supported)</vote>
	\| uses =		\| starting_dose = XR 37.5 mg PO once daily for 4-7 days, then 75 mg/day; titrate by 75 mg every ≥4 days to clinical effect. IR 25-37.5 mg BID-TID
	\| starting_dose =		\| preparations = IR tablets 25, 37.5, 50, 75, 100 mg; XR capsules 37.5, 75, 150, 225 mg
	\| preparations =		\| fda_max = 225 mg/day outpatient (XR); 375 mg/day inpatient (IR divided TID); 75 mg/day in moderate hepatic impairment
	\| fda_max =		\| pill_id =
	\| routes =		\| routes = Oral
	\| onset =		\| onset = Antidepressant effect over 1-2 weeks; anxiolytic effect over 4-6 weeks
	\| duration =		\| duration = 24 hours (XR); 12 hours (IR)
	\| halflife =		\| halflife = Venlafaxine 5 hours; desvenlafaxine active metabolite 11 hours<ref name="effexor-xr-label">FDA Prescribing Information, Effexor XR (venlafaxine extended-release), Wyeth/Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020699s107lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~45%<ref name="effexor-xr-label" />
	~~\| pregnancy~~ =		\| pregnancy = Observational signal for neonatal adaptation syndrome with late-pregnancy exposure; weigh against the risks of untreated maternal depression.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="effexor-xr-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="venlafaxine-mech-claim">Serotonin and norepinephrine reuptake inhibitor with predominantly serotonergic activity at lower doses (37.5-150 mg); the noradrenergic effect adds at higher doses (>150 mg) and the dual-mechanism advantage really emerges then. The active metabolite desvenlafaxine (separately marketed as Pristiq) contributes meaningfully to clinical effect.</vote> '''Severe discontinuation syndrome''' is the marquee adverse-effect feature: venlafaxine's short half-life produces intense flu-like symptoms, dizziness, electric-shock sensations ("brain zaps"), and emotional dysregulation on abrupt discontinuation, worse than most other SNRIs and SSRIs. Slow taper essential. Dose-dependent '''diastolic hypertension''' at higher doses; routine BP monitoring at dose escalation. CYP2D6 substrate; CPIC PGx guidance applies<ref name="cpic-snri">CPIC Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors, 2023. https://cpicpgx.org/guidelines/guideline-for-selective-serotonin-reuptake-inhibitors-and-cyp2d6-and-cyp2c19/</ref>.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	\| ~~interactions~~ = <~~pharmaInteractions~~/>
	~~\| pregnancy_details =~~
	\| monitoring =
	~~\| counseling =~~
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

	[[Category:~~Serotonin–Norepinephrine Reuptake Inhibitors (~~SNRIs)]]		[[Category:SNRIs]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]
			[[Category:Anxiolytics]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:48Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:12Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:53Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:36Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Venlafaxine
+| generic            = Venlafaxine
-| brand             = Effexor
+| brand              = Effexor
-| classes           = SNRI, Antidepressant
+| structure          =
-| mechanism         = Serotonin–norepinephrine reuptake inhibitor
+| classes            = SNRI, Antidepressant
 }}
 [[Category:Antidepressants]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Venlafaxine
| brand = Effexor
| classes = SNRI, Antidepressant
| mechanism = Serotonin–norepinephrine reuptake inhibitor
}}
[[Category:Antidepressants]]