Venlafaxine
Antidepressant — SNRI
Indications
DepressionGADPanicSocial anxiety
Adult dose
Start 75 mg/day (37.5 mg BD or MR OD); titrate to 150 mg, max 375 mg (specialist).
Common side effects
Nausea (dose-related)Hypertension (dose-related)Dry mouthSweatingSexual dysfunctionInsomnia
Serious side effects
Hypertensive crisisHyponatraemiaSerotonin syndromeCardiac dysrhythmia in overdose
Contraindications
Uncontrolled hypertensionHigh risk of arrhythmiaMAOI within 14 days
Monitoring
- BP at baseline, after dose increases, then periodically (esp. >150 mg)
- ECG if cardiac risk
Notable interactions
- MAOIs
- Other serotonergic
- QT prolongers
Notes
Marked discontinuation syndrome — taper slowly. Switching to MR aids tolerability.
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.