Hi. this article says that generic extended-release venlafaxine will not be available in the US until 2010, but I'm looking at my wife's prescription right now and it's generic extended-release venlafaxine (at least that's what it says) and it's July 2009. Did something change in regulations? A lawsuit perhaps? Could someone change this to reflect the new reality? Thanks! 70.105.73.44 ( talk) 03:51, 7 July 2009 (UTC)
After doing some more research I now realize that what my wife has been prescribed as equivalent to Effexor-XR (venlafaxine-ER) is not AB-rated to Effexor-XR [1]. If someone could consider a way to make this clear to the layman that would be directed here by a search engine as he looks for answers, I think that would be great. I was studying the subject because my wife, although on the same dose of venlafaxine-ER as she was Effexor-XR, is having similar side effects to those she would experience if she missed a dose.
Something worth looking in to. We'll have to call the doctor. Anyway. Thanks for pointing me in the right direction! —Preceding unsigned comment added by 70.105.73.44 ( talk) 04:22, 7 July 2009 (UTC)
i haven't been to this article for some time, but glad to see that the reality of the risks of this drug have been put here with the preponderance of studies. The first part of the article doesn't reflect this adequately. 63.250.127.245 ( talk) 01:54, 28 January 2009 (UTC) I have added a comment about the black box warnings as the opening statement is badly misleading and prejudiced to make it seem as if this drug is wonderful and without risk. That is not only disingenous but it is misleading. I suggest that my edit be left in place and if anyhone objects to this, please submit for editorial review. This is a FACT and though i have not put a citation, i am sure all editors know that this is beyond question or argument. it is a FACT.... I found a new website that lists items about SSRI and SSRN's in relation to reported side effects and events in which the group of drugs were named or the specific drug was named .. this has more than a thousand entries.. each which is linked to the actual item for review by readers. this is not a statistical study, but is a factual list of actual articles in media about the drugs...ssristories.com i am not posting this in the references by i do suggest that active editors review this.. as i think it deserves to be in this article about this drug and this group of drugs. I am sure at some point, researchers are going to look at these events as more than coincidental.. There was another mass murder in New York State.. i remember when i was a university student that outrage at the Texas Tower massacre, but we seem to have these events happening with a much greater frequency, and it is not a wild stretch to reflect on whether these drugs are the cause.. 67.208.18.54 ( talk) 19:16, 5 April 2009 (UTC)
The statement that venalfaxine is countraindicated in children and adolescents is not supported by either the references or the data. This is a major error. —Preceding unsigned comment added by 129.255.132.90 ( talk) 17:04, 3 February 2008 (UTC)
I am pretty sure that the black box warnings for this drug do have these contraindications. I believe that was one of the main thrusts of the changes to the usage of this drug and a main point of the black box warnings. I suggest you read the actual script on the Wyeth site.
Szimonsays (
talk)
05:32, 7 June 2008 (UTC)
This section needs to be revised.People editing this article seem to have no understanding on how adverse events are reported and later published. Some of the "rare" adverse events reported for venlafaxine are; menopause, rheumatoid arthritis, cellulitis, tendon rupture and breast enlargement, if one is to mention any of the rare adverse events I feel they need to put it in context.I think it's reasonable to assume that most of these "rare" events are not caused by the medication.Secondly, this article in particular emphasizes the adverse events of this drug and puts undue weight on them.Perhaps mentioning the common adverse events(>5% of treated patients and occurs at twice the rate compared to placebo) would suffice ? -- Tdonner 12:27, 7 December 2006 (UTC)
i added a reference for the mao/serotonine syndrome problem and did minor editing.--- 89.60.228.151 ( talk) 22:36, 24 February 2008 (UTC)
I see another deletion/dilution of the information on the Effexor Petition which is the most exhaustive documentation of the side effects including withdrawal of this drug. If you don't like the composition, edit and revise, but stop deleting this. It is highly relevant to this entry on Wikipedia. People have a right to have knowledge of this that is not minimized or washed down.
- Yeah, there is no difference between "brain attempting to reach neurochemical stability" and "addiction." People simply don't want to take something that is physically addictive so the companies get creative in their wording. see physical dependency. I vote this be changed to reflect that it is in fact, physically addictive.
I agree with these comments. Some of the editors are constantly deleting any reference to this drug being "addictive" and only leaving in Wyeth research both in vitro and animal studies with rather limited application to the actual experience of patients using Effexor. This is supported by some rather narrow perception of what "addiction" means. As this is not a drug compendium and the definition of the term "addiction" is clearly subject to some argument and interpretation, the term "addiction" clearly belongs in the encyclopedic entry for Effexor and is supported by THOUSANDS of users, as well as a number of recognized authorities - the distinction between "physical dependency" and "addiction" is rather a blurred area. One could make distinctions between the impact of addiction on illicit drugs and that of effexor, but clearly patitents who are put on this drug without being advised of serious adverse effects, nor of withdrawal symptoms and are then faced with trying to get off the drug, describe this as being "hooked", "addicted", and "dependent". Leaving this out of the section on physical and psychological dependency is simply ridiculous beyond reason or ethics. Those are are doing this.. STOP..... if you want to argue the issue or provide useful edits that retain clarity, then do so, but stop this nonsense of removing material that is absolutely relevant to this entry.
At medium dosages, venlafaxine blocks the reuptake of norepinephrine as well as serotonin. At about 225 mg/day, venlafaxine blocks the reuptake of serotonin and norepinephrine
Are these two sentences saying the same thing? Ubermonkey 22:33, 22 September 2005 (UTC)
I've been under the impression that one of the common reasons for discontinuation of Venlafaxine in women is anorgasma, caused by delay in the sexual response system. Perhaps this should be listed under common side effects. -Cameron Van Sant 9:11, 12 November 2005 (UTC)
I have commented out this sentence which has to go unless someone comes up with a Wyeth reference for severe discontinuation syndrome:
Please note that this not about the existence of these symptoms but about Wyeth's calling them a "severe discontinuation syndrome". The worst thing I could find in Wyeth's online documentation was: "While these events are generally self-limiting, there have been reports of serious discontinuation symptoms" (see Effexor info for healthcare professionals (USA only)). AvB ÷ talk 13:30, 21 January 2006 (UTC)
Discontinuation of this medication sucks. I get the brain shivers even after missing one dose.-- K8TEK 23:12, 20 April 2006 (UTC)
(First time writing so if this is useless then please delete as appropriate. If I miss just one dose I get a dizzy head-spinning type sensation and feel nauseous. Also I find Myself edgy and unable to stand any slightly uncomfortable situation. This is with or without a knowledge of my missed dose. Gem-Ra! ( talk) 00:04, 5 November 2008 (UTC)
The withdrawal syndrome is fairly well documented, and large numbers of anecdotal reports indicate that it is more common with Venlafaxine than with the SSRIs. It is also treatable by introducing an SSRI medication upon cessation. The paresthesias (electric shocks) are also alleviated by SSRIs, and apparently also by benzodiazepines. Google provides a few references, for example this one and this one, both of which qualify as sources for Wikipedia. However, I very much doubt that Wyeth would emphasise this point in their literature as suggested by the removed line; if anyone has actually seen it on their page, use the Wayback Machine to check that date, and we can source it. Otherwise, it stays out. Zuiram 09:32, 14 November 2006 (UTC)
Dirk is a representative from Effexor. He can't allow people to know this drug is not going to help anyone because he wants money. He is one of those people who values money more than the lives of people. Don't buy in, don't give him what he wants, spit out your Effexor. —Preceding unsigned comment added by 65.79.138.222 ( talk) 05:07, 23 August 2008 (UTC)
If you have direct evidence that Dirk is a representative that should be posted here as it may have impact on his position or not, but if there is no direct evidence, then this is pure speculation, and it verges on defamation to imply his views would be due to this relationship. So, either post it or the comment is worthless. 63.250.127.245 ( talk) 00:28, 22 February 2009 (UTC)
someone removed the link i had placed to the Effexor Petition. There is no reason why this should be removed. This is an honest website with 11,000 signatories, most describing their experiences with this drug. This is an important element of patients saying what happened to them and it should remain here so those who look up this entry can see this perspective. This should not be removed again please without any explanation. I will replace it if it is removed again.. and no one needs to have an editing war. If you have a reason why, state it. We are not in a dictatorship where information is screened by the "truth police".. There is tons of information on side effects, but the petition site is one of the few in which patients tell of their experiences,, THOUSANDS OF PEOPLE.
I ;put the link back and someone has removed it again.. STOP THIS NONSENSE... THAT IS NEARLY 12,000 EFFEXOR USERS WHO DESERVE TO BE RECOGNIZED AND WHOSE EXPERIENCE DESERVES TO BE HERE... STOP REMOVING THE LINK WHOEVER IS DOING THIS...... 12,000 PEOPLE AGAINST ONE... WHOEVER IS REMOVING THE LINK.....
Dirk, as i have commented before, you are doing a disservice to readers by censoring useful and relevant information about this drug. The page on anti-depressants has a section on controversy, and effexor has plenty of controversy on its own .. Readers have a right to know this and not to have one person contantly deleting material added by others that is relevant to the current knowledge about this drug. This is relevant information about this particular drug and readers should have the right to know this specific information aobut this drug. The material i add is not my view, or judgemental, it is information provided by researchers and also by thousands of users... a separate link is fine for the larger material, but this does not preclude paragraphs making this knowledge readily available to the Wikipedia audience who deserve to have this information THERE on the main page for Effexor. Censorship is not part of the wikipedia philosophy except for inappropriate material such as racism. The full story on the SSRI's and SSRN's is not yet done.. Effexor is the riskiest of this group, and this needs to be imparted without blocking reference to the petition, nor of the reality of practices in the prescription of the drug that put people at risk. I am not going to stop ensuring that this information is there.. I suggest the editing war stop so that the appropriate material is there in an appropriate form. Sam
I note that some of the points made require references.. i will find these.. the comment about the user info stating "unpleasant" was in the previous user info.. I replaced that one with a more appropriate user info that is more up-to-date and reflects the side effects in more realistic terms. the note about doctors over-prescribing is from a guideline.. but it may take a bit of time for me to find the actual document.. The issue of whether Effexor is addictive or users are drug dependent is really a distinction of semantics more than anything else.. There are some varying views on the definition of addiction. Many users who have suffered the effects of withdrawal use the term addicted when describing how they view the impact... The term is used in a variety of ways and is perfectly OK in this context as well. I am not changing this for now, but I will be do so when i have reviewed the usage of this term more fully. At that point, i will leave the current descriptions in, but will add the broader perspective of addiction that is used in language and that is necessary in this entry as well. Let the reader make up their own mind about the usage of the term here. I appreciate that we don't get into an editing war again. The final verdict on this drug is still not out yet but the thousands of users speak very loudly to the issue. Sam
Filed in 2004 due to the discontinuation of the drug side effects. www.effexorwar.com which leads to http://www.pcalawfirm.com/
As of 12/10/10, both of these links are dead. —Preceding unsigned comment added by 76.115.191.41 ( talk) 06:14, 11 December 2010 (UTC)
Does anyone know the difference between Effexor and Effexor XR? I have looked extensively on the web and there are two ideas regarding the difference. the first being that it is slightly different formulation. The second is that it is a controlled released drug. Meaning that the drug is absorbed over a longer period of time supposidly giving less side effects. I can not find anything from Wyeth. Any help on this would be much appreciated. -- benjaminevans82 July 2006
From the article:
"At low and medium dosages, venlafaxine inhibits serotonin reuptake alone, similarly to a selective serotonin reuptake inhibitor (SSRI). At higher dosages (from about 225 mg/day), venlafaxine inhibits the reuptake of norepinephrine as well as serotonin. At high dosages (starting around 300 mg/day), it inhibits dopamine reuptake in addition to serotonin and norepinephrine."
Would it be possible to get this subtantiated? I see the claim repeated multiple times on various web sites, but never with proper citations. -- Supergloom 17:45, 20 July 2006 (UTC)
"Preclinical studies have shown that venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), are potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake."
I have also noted how several web sites claim that venlafaxine affects diffrent neurotransmitters depending on the dosage.I'm almost certain this is not the case however.
Someone asked me via my talk page about venlafaxine dose and how it relates to neurotransmitter levels. He wasn't a registered user, and I'm not even sure this is the article he's referring to, however, here is his question and my response:
Feel free to contact me via my talk page if you need more info. ZZYZX 10:38, 31 August 2006 (UTC)
These are not actually footnotes, but are references. Footnotes will appear at the bottom of a particular page of text in a book or in a scientific paper, but when references are listed at one location at the end of an article, these are not actually footnotes.Can someone advise how to add to this section as the actual references are not visible.I cannot add sources at present time.The requirement to add citations for some items and not for others is rather confusing and arbitrary. There is a lot of material here that is not at all referenced. One could nit-pick and ask that every sentence be referenced and that would be ridiculous.Some information is so well known and often mentioned in literature on anti-depressant drugs,that asking for a citation is redundant, for example, if a person is taking alcohol or other drugs, this comorbidity increases risk when taking an anti-depressant and is on all information sheets for the drug -- this is very well known and hardly requires a citation. I am deleting the request for citations in such cases.
Could you advise on how to add a reference.. The listed footnotes are not actually footnotes. These should be titled References. Footnotes are typically placed at the bottom of the specific page where they are noted by a number, not at the end of an article. I will find the reference to some studies showing that the actual effect on reducing depression by Effexor when compared to placebo is negligible. There has been some amazing work done on placebo effect, in which effects of a drug for Lupus were mimicked by placebo when the patient did not know de facto whether the medicine taken was the drug or the placebo. I am sure this doesn't always work, but rather amazing stuff to read. As I noted above,the comorbidity risk for suicide is very widely known and appears in guidelines for Suicide Prevention, and for treatment of both Bipolar disorder and Borderline Personality Disorder. One of the papers I listed includes this but I don't know how to add to the references as the edit sheet does not list the references (called footnotes, but not actually footnotes, unless my knowledge of the convention is incorrect. I appreciate it if we don't get into editing wars. The material I add is not without support. e.g. section on the word "addiction". An encyclopaedia is not a drug compendium, and therefore information about effects on patients and patient feedback should be as important as strictly clinical material. There is a tendency for drug companies to overemphasize the positive effects and minimize negative effects (e..g. "unpleasant" side effects), therefore the overall entry for a drug should be open to adverse views based on evidence and on opinions of recognized authorities e.g. David Healey, Glenmullen, Breggin as well as a forum such as a petition by users now more than 12,000 strong. Sam
I checked the references for the last cut/slash/replace edit and found these to be not supportive of the script. One of the references actually was based on "perception" of general public and not that of actual users of Effexor. I will keep putting back the correct material in this. I don't know who is doing the cutting, but you are ignoring the experience of more than 12,000 people and who are you to make this distinction that severe withdrawal does not swignify dependency. That is exactly what is meant by physical dependency --- a need for the drug to not feel sick, bad, anxious and the entire host of severe withdrawal symptoms that are well known. Why are you a supporter of effexor???? There are users who benefit from this drug and are ok with being on it forever, probably millions of people, but there is a reality of 12,000 users who have had bad effects and this reality should not bve watered down. Sam
Notwithstanding our respective positions, Best wishes, Sam
Mr. Bungle.. what is this supposed to mean? This is not what severe discontinuation syndrome is about. People have tried to wean themselves off this drug and you want to blame them for "non-compliance"?. You are discounting the real experience of people on this drug with this kind of language? This is not reality. "Often patients recognize the link between noncompliance with their medication and discontinuation symptoms and may describe their experience as dependence or "addiction".[13] Your comments are not grounded in this reference. The word addiction and dependence do not appear in the abstract. Is this a quote from the article or your own filter to the abstract that does not mention either of these words or even comment on dependency. I will wait for your reply. If it is your filter, then it is not an accurate representation of the article. If I don't hear a response, I will delete that section and replace it with another referenced comment that will accurately reflect the literature. Sam
Changing the heading from Physical and Psychological Dependency to Drug Abuse and Dependency is clearly incorrect as the section says nothing about drug abuse. I think both of us should research the term drug dependency to come to an accurate description of what this actually means. I am willing to let go of the term "addiction" except as a comment that users state, and stick with the meaning of drug dependency. Read the section on withdrawal in Wikipedia. It confirms that anti-depressants cause drug dependency. It is a well written piece and deserves a link. Taht is good enough for me. Sam
Re the article I cited: The abstract is a 257 word summary of the article, the actual article is 5000 words and 14 pages long, it can be accessed via ingentaconnect at full text this is subscription only and will cost you to download the pdf (alternatively if there is a university library near you can go down there and download it or make a photocopy). The comments from this paper summaries what is known about discontinuation/withdrawal syndromes and I highly recommend reading it.
I didn't change the heading but changing it back is fine, drug abuse and addiction are traditionally discussed together as most drugs which cause dependency are characterized by compulsive drug-seeking and abuse behaviors. A definition of dependence from the diagnostic and Statistical Manual of Mental Disorders put out by the American Psychiatric Association.
Here is a simplified version: A maladaptive pattern of substance use, leading to clinically significant impairment or distress as manifested by three or more of the following, occurring at any time in the same 12-month period:
In terms of these definitions most antidepressants have no clinically significant potential to cause dependence. Lets do venlafaxine: 1. No, 2. Yes, 3. No, 4. Maybe, 5. No, 6. No, 7. No. As mentioned in the article lots of drugs cause withdrawal effects are not thought of as addictive.
I suggest reading Wikipedia:Footnotes for more information on footnotes and how to use them (you can probably also get an idea just by editing the page and looking at how they are set up, just dive in, if you make a mistake someone will fix it). If David Healey, Glenmullen, or Breggin have published work on the subject then it can be added (with a cite) and there would be absolutely no problem with that. Your personal experience (good or bad) should not cloud your judgment and lead to biased information in an article, we need to remain neutral. I don't work for Wyeth or particularly support effexor, but if it wasn't for me (and others) this article would be one long diatribe against the evils of venlafaxine. There is a large amount of evidence in the medical literature about the benefits of this drug (albeit studies probably supported financially by Wyeth) but even so, no scientist is going to fudge results just to paint a 'rosy' picture of the drug. All drugs have risk and benefits we need to weigh them equally and not over emphasize the negative (or positive). I added the opinion poll as antidepressants and mental illness in general have a stigma about them. Most people on the street already think antidepressants are addictive when generally they are not. The petition reinforces this perspective, I am not comfortable with the petition being mentioned for reasons stated above, but I let it slide as people do have the right to know it exists. I have left in some of your information intact, but I plan on editing it in the future (mainly because you use such emotive language). I could care less what order the external links are in, so go hard on rearranging them. We also seem to have taken over this discussion page, if you want you can move it to mine or your discussion page. Mr Bungle 06:04, 7 October 2006 (UTC)
There is plenty of evidence that the risks of the anti-depressants were largely minimized and there is still major concern that some of these drugs may be causing violent behaviour in some individuals in addition to the increased risk of suicide ideation. This is why any article on an anti-depressant drug must have this information in balance. Everyone has different writing styles. Your edits on the dependency section always try to put attitude about dependency or "addiction" as a prejudice or ignorance of patients. This is not balanced - not at all. We know that effexor does not have the effect of heroin, or cocaine, or amphetamines, but we are talking about physical dependency, and just like nicotine, if a user feels uncomfortable without a certain titer of a drug in their system, or if the effect of not having gthat titer is severe, then the distinction between "dependency" and word "addiction" is really more semantics than actuality. Nictotine dependency or "addiction" is certainly not the same as opiate derivative dependencies, but any smoker will tell you that they are addicted. I think you need to revise your entry in the physical and psychological dependency section as it is just not balanced and it basically minimizes the severity of dependence. I am sure that any user trying to get off effexor will disagree with you from personal experience, and to argue against that is like telling someone that a toothache is in their imagination because the dentist can't find the source. As i have noted elsewhere, the full story on anti-depressants is not out yet. I am glad that you have left some of the advice elements i wrote in the article. These can save lives and need to be there, and if you look at the current sheets on effexor by wyeth and others, these are there in detail. You must also consider that the black box warnings do shift a lot of responsibility to physicians and away from wyeth, but with Wikipedia as a known source of information, there is an ethical responsibility by editors to present the facts and NOT to dilute reality by making it seem as if users' experiences are merely subjective and not real. A recent paper links reduction in suicide rates with start of use of the SSRI anti-depressants, and i have seen concerns published through the APA by particular clinicians of the view that the black box warnings and negative publicity might cause deaths by suicide as patients do not take anti-depressants. This was a rather disingenous positon as it presumes that patients should follow advice of the doctor and not be "frightened" by possible side effects. Healey speaks to how psychiatry has moved more to drugs than to non-drug therapies. There was a tendency among general practictioners prescribing anti-depressants with no advice to patients or families. Once a kid was 16, some doctors did not even consider it necessary to inform families. The black box warnings have changed this dramatically as they place accountabiity on doctors even more than on the drug manufacturer. There is a similar controversy about use of Ritalin - concerns about over-prescription of this drug on the basis of inadequate and shoddy diagnosis, or as a crutch for teachers who do not know how to manage children or youth who may be inherently hyperactive. Diagosis is mostly based on testing that is highly subjective. Taht is not to say that there are not kids with ADHD that benefit from the drug, but many doctors are not even aware of the fact that Ritalin is also a street drug, and kids are getting hurt -- one of the side effects of Ritalin addiction is behaviour that mimics OCD, so kids may be diagnosed with OCD because of doctors not knowing how to detect ritalin addiction (it is snorted like cocaine, and the effect is similar). Mr. Bungle, this is an area in which an editor must be very well informed. One article does not support a fact necessarily. The effexor entry must provide good information to users - and not be merely a "compendium" type of entry. I have said it before, but an encyclopedic entry must give a lay reader balanced information that enables them to understand a subject in a broad context. I left in your opening entry about receptors for opiates, etc., being different than those for effexor, but this hardly answers the question and most lay readers won't even know what you are talking about. Effexor does impact more receptors than the other SSRI's as it is actually a SSRN. What does that mean in terms of effect on the patient.? Perhaps a better lay explanation would be of benefit. I am not expert on neurophysiology though I have perused presentations on the action of various drugs on the CNS. At any rate, the bottom line is that the entry must give balance. We are on the left and right of this right now, but I do believe we can improve the entry and in this do a service to readers. I cannot but recall a famous case about 20 or more years ago in which a particular drug was used for severe cases of acne, but doctors who prescribed it were not aware of one very serious but rare side-effect. That side effect was anaplastic anemia that was untreatable and FATAL. Did not happen very often , but when it did, the cost was unbelievable to a family, to the patient. There were about 300 cases per year in the U.S. When this was revealed more widely, the question then to patients and their famiies was - "is the cure worth the risk?" The drug was then taken off the market. The drug company simply did not put much emphasis on the risk. Mr. Bungle, this is the moral issue in writing about a drug on Wikipedia. The article must be balanced and fair. And there is clear ethical responsibility of editors to do that. WE are lay people mostly, and the entry is not a scientific dissertation, but the material must inform. I will try to learn the citation methodology so i can add these where i can. Please respecxt my entries as I will respect yours. If I disagree, i will post here. and vice versa. I am sure we can make this article better. Sam
I am afraid that I am a novice in messaging in Wikipedia. I do my best to contribute honestly to entries and that is what I have tried to do in the Effexor entry.
It is sad and scary that this article is on the first page of google search results for Effexor. If you are looking for any accurate information about this medication, stay away from this page, and the wikipedia pages of any other psychopharmaceuticals. Many of the people editing Wikipedia are seriosly mentally ill, whether psychotic, delusional, or paranoid. By editing Wikipedia their paranoid delusions, previously shouted on the street to strangers, become respectable.
While there are plenty of reputable people editing Wikipedia, at any given time you have no way of knowing whether the version of the page you are reading is written from the POV of a doctor or an untreated mental patient. It may be reasonably accurate for an hour, then full of misinformation and bias the next. While an article on, say, calculus can usually be considered to be accurate, articles on psych medications tend to attract the genuinly insane- people who have been prescribed these medications and need to warn the world of the evil doctor-conspiracy to control their minds.
This is one case where you really want to stick to the real encyclopedias if you want to be sure to get factual information. -- 72.19.81.122 18:11, 9 October 2006 (UTC)
I had written a long reply to this comment, but lost it, so must make this brief. Wikipedia has been compared to hard copy encyclopaedias and online versions and has been given a good rating with respect to accuracy of entries. I am confident that the vast majority of people who do edits here do their best to contribute useful information. I would never edit an article if i did not have some knowledge to be able to contribute usefully, and i imagine that most people operate like that. The accusations in the above rant are pure nonsense - truly. The article has improved in providing better information to readers. Any reader who has more than a passing interest in the anti-depressant drugs in particular and Effexor specifically can do a search on the net and check some of the information. I am confident that they would find that the added material is relevant and factual.
Wikipedia is generally a fairly useful starting point, which is what an encyclopaedia should be. The psychopharmacology sections, however, are often fairly inaccurate. I do not, however, have a paper encyclopaedia around to compare it with, so I'll refrain from commenting on that. This said, anyone choosing to trust wikipedia (without reading the sources) over their psychiatrist's advice is out of their mind, and hence the majority of the errors and omissions are of little consequence. Zuiram 09:38, 14 November 2006 (UTC)
I agree. Non-experts often hold excessive skepticism for wikipedia articles. When questioned about the accuracy of information on wikipedia, usually they say it is high quality.
The0ther
00:28, 5 December 2006 (UTC)
One of the editors is again diluting comments about addiction regarding this drug. I have read commentary about this issue, that the drug companies prefer to use softer language e.g. severe"discontinuance" effects, rather than severe "withdrawal" effects. The terminology is ridiculous as there is no difference between the two. I have replaced the comment about "addiction" and removed the silly attempt to blame patients.. my goodness, how far can someone go to try to whitewash a real effect!!!!!! Blame the patient!!!! Most of those suffering the effects are people trying to get off the drug, not patients who are refusing to take the drug properly or withdrawing quickly. I have deleted that bit of ridiculous blaming of patients. Szimonsays 01:29, 30 October 2006 (UTC)
Nothing I changed can be remotely construed as "blaming the patient". I have been removing your specious and uncited argument about the differences between effexor and hard drug withdrawl being the result of "semantics". If you can find a reputable source that makes this argument, we can discuss how to integrate it into the article in a logical and relevant manner. However, you have not shown any inclination to do so despite multiple requests. You have been repeatedly told to review WP:NPOV and WP:NOR, which you clearly do not yet understand, and I think your long, emotional, and at times unintelligible rants on this talk page serve to demonstrate that. Skinwalker 02:21, 30 October 2006 (UTC)
I am not experienced at putting down citations. Your one reference to the term "addiction" and your language implying that this is caused due to patients not following instructions without really addressing the factual issue is ridiculous. That is how I construe this, and it is clear to me that you do not understand this and want to soften the impact. It is not the patients who are the problem. Not every comment has a citation, though I don't disagree with certain information requiring clear references, however, the semantics of the word "addiction" is mentioned elsewhere and can be easily be reviewed by readers. Why do you persist in not addressing this and trying to give the impression that the users of effexor do not find this product addictive. They, more than you or me, speak to the experience of using this drug and the devastation of withdrawal (not discontinuance as a softened expression of the effect). I will continue to add my comments .. as they are valid. If you want to research this go ahead, appropriately, please be my guest. But you are writing in a tone that puts the blame on patient behaviour. You talk about patients "recognizing non-compliance" - if you do not see the implication you are living in your own delusions. Here is a patient comment.. READ CAREFULLY PLEASE.. "I have been weaning from this drug for almost a year now, and I still must take 75mg every few days, I wait until I can not stand the sensations: electrical zaps in my head that get worse and worse, until I feel like I can not even walk straight, and the hurkey jerky movememnts are horrible. My physician does not believe me and wants me to let go of the last bit, as if it is all in my head, but it's not, and thankfully I have had some left over from when I switched to cymbalta. I don't know what I will do when I run out. I was suicidal before." You are also not complying by calling my comments "rants" and "unintelligible".. hardly reality. Look at yourself in the mirror first. I will find a link to an article on this concern that was written in 2005. Meanwhile I will be deleting your distortion until you stop deleting my comments. yes, we should find references, and if you are honest about integrity in information you will do the citation on my behalf. The term addiction is not as you would wish to want it to be here. It deserves to be handled here in a way that the average reader has a clear understanding of what this really means.. not a distorted censored meaning that hides reality.. Szimonsays 14:15, 30 October 2006 (UTC) READ WIKIPEDIA ARTICLE ON ADDICTION.. This is my reference, and i have added a link to this article on the subject in the article on Effexor. Let the reader decide because obviously you and I live in different universes of what truth is about. Szimonsays 14:30, 30 October 2006 (UTC)
OK Dirk, sorry if my last edit was choppy. It was morning and I was revising again against a time constriction. I look forward to seeing your balanced edit. I reiterate my point that information must be balanced and not written from a subjective point-of-view. The area of controversy in anti-depressants is such that an editor could find references to support this or that perspective while actually distorting the reality. I believe that this article has improved dramatically in the past few months and now represents a very balanced presentation. This is very important as many people use Wikipedia for information, and I know that edits that try to water down facts are just not honest. Others have expressed this view here in the editing talk, but I have made a personal commitment that the information here is truthful and not a distortion of reality. I met tonight with a young woman who was a former user of this drug, and she told me how it frightened her in its impact on her mental health. That is not to say that the drug does not help many millions of patients, but the risks need to be clearly presented here. Otherwise, the article might as well be a series of links to key articles about the drug, and let the readers decide which is more honest and truthful. Balance in editing is a key factor of what gives Wikipedia its strength. Not one person deleting facts that are supported by links within Wikipedia itself (e.g. the term "addiction".) Thanks again Dirk. I trust you will write something that reflects the truth clearly. Szimonsays 02:01, 31 October 2006 (UTC)
Dirk, if what I just read on addiction in this article is your attempt to find balance, I am sorely and sadly disappointed because it just supports the same narrow view of the definition of addiction that is totally inadquate for this article. I hope not. I will check tomorrow hoping that this is not the case. I am adding a separate comment about the defnitiion of the term "addiction" linking this to the article on addiction in Wikipedia. If you think this is not appropriate, then they better delete that article too. I do hope this wasw not your attempt at balance, because it really still tries to soften the impact of this drug at withdrawal, and uses that sleight of semantics to try to make readers think that this drug is NOT ADDICTIVE. It is clearly addictive by general terminology. this is the actual description in the article on addiction in wikipedia "To wit, pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence);" and this is my point - as well as the fact that users of the drug consider it to be addictive as there is a dependency on it. The edit just does not make that clear statement but continues to try to distort truth. Enough is enough. Dirk, this has to stop. I will leave the references to the other point of view, but my argument is as well supported and deserves to remain. Otherwise the war will not stop because i will not leave this distortion of truth to stand. Szimonsays 02:14, 31 October 2006 (UTC)
someone has again deleted the comment about the Effexor Petition. This is really sad and annoying. I am pasting a reference here to support my edit http://www.cmaj.ca/cgi/content/full/170/4/487?etoc The fact that someone would now remove the very important item about the effexor petition says a lot about the sad corruption of this article to hide reality. That section has 12,000 users who deserve to be known here. Their testimony is reality and it should not be deleted. Whoever is doing this is really a lowlife. Szimonsays 22:05, 31 October 2006 (UTC)
Someone has once again removed the material about the effexor petition. I request that editors determine who is doing this and ask them to desist as this is relevant information that needs to be here. If they persist they should be subjected to sanctions. 66.241.132.98
I have read the guideline Skinwalker... I am pasting here for your information..
"Wikipedia has a neutral point of view, which means we strive for articles that advocate no single point of view. Sometimes this requires representing multiple points of view; presenting each point of view accurately; providing context for any given point of view, so that readers understand whose view the point represents; and presenting no one point of view as "the truth" or "the best view". It means citing verifiable, authoritative sources whenever possible, especially on controversial topics. When a conflict arises as to which version is the most neutral, declare a cool-down period and tag the article as disputed; hammer out details on the talk page and follow dispute resolution." You are violating the guidelines by not allowing a neutral point of view by excluding relevant information. Not all information must be verifiable in the strict context - and the Effexor Petition clearly is in a category that the sheer volume of specific reports of experiences that can be seen to be common across THOUSANDS OF USERS give this information validity by preponderance of numbers to the repeated details. The history of the information about the anti-depressant drugs has been heavily weighted against users, and this is very very well documented. Readers are entitled to know about the Effexor Petition within the article. Stop being a censor when censorship is not needed. My script on this was very balanced and fair. I will ensure that readers are given this relevant material in the body of the article. How many times have you seen a petition now nearing 14,000 (of which some are blank and a very few are junk) in which patients tell of their experiencesa with a drug. This is the power of the openness of the internet, and it is also part of the power of Wikipedia. You demean this by your actions. I think that the information provided by 13,000 people deserves two neutral sentences and you as one individual should not act as a censor for whatever distorted reason you have. Szimonsays
Some recent news seems to show SSRIs to have a much stronger effect in preventing completed suicide. Here is a quotation from the article on eurekalert.org:
individuals taking an SSRI known as fluoxetine had a 48 percent lower risk of suicide (6.7 deaths per 1,000 total years that individuals took the drug) compared with those not taking medication (11 deaths per 1,000 years), while those taking venlafaxine hydrochloride, another SSRI, had a 61 percent increased risk (22.5 suicide deaths per 1,000 total years of medication use)
source: Antidepressants associated with increased risk for suicide attempts, decreased risk for death
The0ther 00:13, 5 December 2006 (UTC)
—The preceding unsigned comment was added by The0ther ( talk • contribs) 00:13, 5 December 2006 (UTC).
The only information in the article currently on patent status is in the intro:
I think the situation is actually fairly complex, but I don't have good references at the moment to write anything better. But here is what I understand the situation to be. The compound itself, venlafaxine, is still patented by Wyeth; the patent expires in mid-2008. Wyeth filed in 1997 for a separate patent on the extended-release form, marketed as Effexor XR, which expires in 2017. However Teva challenged this latter patent; Wyeth's case didn't look too good, so they settled it out of court to avoid having their patent actually overturned. As part of the settlement, Teva was given a license to sell "authorized generic" versions of Effexor beginning in mid-2006, two years before the patent is due to expire. So while it's technically true that "generic venlafaxine is available", it's only available from one specific company as part of an out-of-court settlement—it isn't out of patent yet, and is not available from the full range of generics manufacturers. -- Delirium 12:06, 12 December 2006 (UTC)
I am amazed at how this document has gradually softened and reports in the literature advising that Venlafaxine has the highest risk for suicide ideation are just not represented here at all. The tone of the article suggests rather that the risk is all in distortion of studies, rather than in actuality of findings.
I just have not had time to address this or to compile the references showing this presented by studies. The last study I read gave a factor of at least 2 times risk of suicide ideation - and the group was not selected for those individuals specifically at risk. Healy reported that normal patients without any depression or known risk factors had increase of suicide ideation and there was a case of a young woman in a study of Prozac who actually committed suicide during the study. I just do not believe this article is currently balanced and it does not properly represent the two positions now taken by scientists about this group of drugs nor Venlafaxine that is considered by some to be the most risky of this group for some patients. As noted in the review of the Healy case - a risk factor of 1 in a thousand may seem low for some procedures (for example, for angiograms that factor is considered acceptable when compared to a risk of death by heart attack), however, the number of angiograms performed annually compared to the number of users of SSRI's or SSRN's is miniscule and the risk factor of 1 in a thousand when expanded to millions of users, is huge. It is also clear that most prescribers simply do not follow the recommendations for precautions and care in patient management. This has in fact been reported in studies.
This article needs a careful review and update to balance the information presented, as it is currently weighted in favour of the drug's use with the risks being minimized and studies showing these risks not even being presented here fairly. I am glad that at least some stuff remained in the article, and it was a battle to even keep that stuff in, but I am disappointed how this piece has become so badly distorted. wow talk about misinformation. The Effexor petition is certainly more than just withdrawal effects, but hopefully some readers will use the link and get some real information on user experience.
I will be getting my references together as I find time, and putting more information here with references to put this article back into the realm of reality rather than distortion by exclusion.A fair appraisal presents all arguments fairly until such time that the preponderance of evidence supports information to a point of clarity and balanced reporting. That is certainly not the case here as yet. 66.241.132.98 21:28, 15 January 2007 (UTC)
I was disconcerted to see the FDA equated to Federal Drug Administration. It is not ! The acronym FDA stands for Food and Drug Administration. It controls the pruity of both foods and drugs.
Nwbeeson 17:43, 12 February 2007 (UTC)
Is it time to have a section listing all the various brand names for venlafaxine in use around the world?
International Brand Names
* Depurol® (CL) * Dobupal® (ES) * Efectin® (AT, CZ, HR, HU, PL, RO, SI, YU) * Efexor Depot® (FI, SE) * Efexor XR® (AU, ZA) * Efexor® (AR, AU, BE, BR, CH, CL, CO, CR, CY, DK, DO, EC, EG, FI, GB, GT, HN, ID, IE, IL, IT, JO, KW, LB, LU, MT, MX, NL, NO, NZ, PA, PT, SE, SG, SV, TH, TR) * Effexor Paranova® (DK) * Effexor® (FR, IE) * Effexor® XR (CA) * Elafax® (AR) * Faxine® (IT) * Flavix® (IN) * Norpilen® (CL) * Trevilor® (DE) * Vandral® (DK, ES) * Velafax® (HR) * Venlafaxina Combino Pharm® (ES) * Venlafaxina Dosa® (AR) * Venlafaxina Masterfarm® (ES) * Venlafaxina Ratiopharm® (ES) * Venlafaxine-Apex® (NL) * Venlax® (CL) * Venlor® (IN)
cut and paste from here: Merck.com DanBeale 11:05, 6 March 2007 (UTC)
There's a lot of POV pushing going on in this article. Some people seem to be adding stuff without talking about it first, and others are reverting without checking what they're reverting to.
Is there anyway that the "I don't like it" stuff could be put in a neater section? DanBeale 23:51, 15 March 2007 (UTC)
The common side effects list includes "weight gain". Someone changed this to "loss of appetite" included, but this was reverted as vandalism. I've put it back in, and included "weight gain" too. See these links for the "loss of appetite" claims. Priory 'focus on venlafaxine' netdoctor uk information (taken from the patient information leaflet for venlafaxine in the UK) DanBeale 17:10, 22 March 2007 (UTC)
Venlafaxine is no longer prescribed in primary care in the UK because of the risk of heart problems. This isn't something we've highlighted and is probably lost amongst a vast list of potential side effects. The revised guidance from the mrha (medicine and healthcare products regulatory agency) is here. From December 2004 it's only been prescribed by specialists, and is to be prescribed after SSRIs have failed. The risk is cardiac ventricular arrhythmia. The guidance seems to have been relaxed slightly in 2006. The National Institute for Health and Clinical Excellence has in its depression guidelines the following:
The NICE guidance is how venlafaxine is to be used in the National Health Service and hasn't been revised to take into account the info from the MHRA. We need to put some of this in the article. Secretlondon 20:12, 23 March 2007 (UTC)
Code | Result | |||
---|---|---|---|---|
|{{ User:UBX/Venlafaxine}} |
|
Usage |
-- One Salient Oversight 01:47, 4 May 2007 (UTC)
More emphasis needs to be given to the side affects assocaited with effexor, and more notice need be given to the petition. To those who constantly remove mention of it, I must seriously ask, which do you hold in higher esteem, Wiki's policies on "reliable sources," or people's lives? Like it or not, people use Wiki; that's what it's here for. When it comes to something like drugs, the water need be treated very lightly and carefully. We are dealing with a drug here that currently in excess of 10,000 people claim has ruined their lives. I am sad to say that I can count as 10,001. The things described in that petition are very real, and it deserves much more attention in a supposedly accurate and thorough academic article than a miniature citation near the bottom of the page. When the safety and well being of human beings are at stake, I say that at the very least it mildly supercedes the stringent rituals of Wiki editing. Then again, perhaps I am wrong; but I had no idea that Wiki had joined the hallowed halls of freedom, safety, and democracy as an ideal placed above the value of human life. 209.169.89.240 20:14, 10 May 2007 (UTC)
If 12,000 people using the drug report similar experiences at withdrawal, deleting this from the article is irresponsible. You devalue the personal experiences of users, and the number of users exceeds the number of subjects in most studies. If a scientist took the time to sort the survey input into effects, this would be a powerful "study". This does not mean that the drug is not of value for some people, but when a drug has effect on the brain, the risk of side effects (look at the list in the article) may be very high for some individuals. It is not your job to censor valuable information in this article even if you do not agree with it. Please let the Wikipedia reader have the benefit of the personal experiences of users. Such information provides potential patients insights that they can share with their physicians to determine if they should use this drug. One of the major problems is that most prescribers do not take risks very seriously, and in cases of actual suicide hide behind the defence "the patient had chronic depression and depressed people do kill themselves. Sometimes! not always, and if there is a risk with a drug, this should be communicated to patient and to family.
the petition serves this purpose and is a very valuable resource in this article.. Please do not delete section again. I will reinsert and lodge complaint to mediation if necessary.
anyone with a knowledge of risk of both ssri's and the greater risk with effexor and a bit of common sense would not delete the comment on the effexor petition. Sam B
Dan.. your arguments for censoring (it is not editing really) reference to the effexor petition deserve nothing more than disdain except that your censorship is harmful to those who seek information on wiki. Your notion of "reputable" and "verifiable" as applied to the petition are ridiculous. By your standard every election would be invalid as the voters are not "verifiable" or "reputable".. While there may be some petitioners whose feedback may not be reliable, the sheer preponderance of numbers as well as the fact that the information is of known effects of effexor give the petition weight. It is now nearly 15,000 strong. It is noteworthy that some of the "reputable" sources you give so much weight to have been impuned for distortion of reporting of findings, and false reporting is not unknown in the scientific community. Wiki has recently implemented new software to screen editing by vested interests such as employees 0f firms that may have strong negative reports - an example given is watering down of the oil spill disaster by Exxon. The petition stands by sheer numbers as both "reputable" and also "verifiable". You cannot get 15,000 individuals reporting similar life experiences as a "plot". Get serious!!!!! The petition represents real people giving real experience.. Stop deleting the reference to this in the body of the article. It is inevitable that in time researchers will give a fair appraisal to SSRI's and SSRN's such as effexor both for their positive uses and for caution to prevent tragic deaths. That is why the petition is so important. I have not had the time to add back the reference, but i will do so, and I will lodge a complaint if you persist in deleting relevant information because you don't agree. It does not matter that you do not agree. Your arguments are not valid in any case. If you want balance in that - which has been there many times.. describing what the petition is, and the fact that it is anecdotal, but it is powerful just that same and the 15,000 who wrote their input certainly have the right to be heard here Dan... More rights than your deleting this cause you don't agree.. Sam —The preceding unsigned comment was added by 207.61.84.162 ( talk)
Skinwalker... I do not appreciate your deprecatory statement about my comments as "rants". You are using a classical "ad hominem" argument (i.e. attack the person). Personally, I could care less what you think about my comments. We have disagreed before, and this is what makes democracy - that right of people to express differences. I have read the comments about Wiki policy, and while I still don't agree with this in the context of this subject matter, I will not make any further changes at this time, at least not until I am able to support this in relation to Wiki policies. I am, however, glad that the article has improved significantly. I just read the Effexor Petition again today as this is a dynamic document - and the entries are truly heart-wrenching. I never put any content of the petition in the article as this was not appropriate, but I wanted readers to at least know it existed. I am pasting just one recent entry here in the discussion. " found this petition while trying to research Effexor. I was recently prescribed this drug. My reason for researching was because I started to feel worse depression after starting it - I wanted to know if this was normal. I have taken other antidepressants and have not had these strange feelings before - like I am in a dream, hard to focus, empty. I am scared of going off the meds because of what I've read here. But I will stop taking Effexor - It is not worth the risk. My doctor did not tell me anything about withdrawal or side effects. She seemed all too eager to switch me from Prozac to Effexor. I wondered if the Wyeth-Ayerst sales rep was giving her really cool coffee mugs or something. It's not just the pharmaceutical companies that need to grow an conscience - it's also the doctor's who prescribe them without adequately researching them." I am still of the view that anyone who was researching this drug would appreciate a link to the petition in the article. For those who have actually lost family members to suicide with this drug as a possible trigger, I can assure you they wish that someone had warned them. A similar case some twenty years ago was a drug used as a treatment for severe acne, but one relatively rare side effect was a fatal disease of the blood "anaplastic anemia".. My pharmacist thought this was Accutane but when I checked that is not a side effect. Accutane however, does have very serious side effects and is used as it works so well for acne, but only under very very close supervision and some major restrictions - and is rarely ever prescribed by general practictioners. Well, I have the challenge of seeing in what context a reference to the petition will be permissible in Wikipedia and I am looking forward to a positive resolution of this. 207.61.84.162 23:16, 3 November 2007 (UTC)Sam
From the Wyeth web site:
It goes on to mention elevated IOP as a side effect. It seems to me that this is primarily an angle-closure Glaucoma problem, not a general glaucoma problem (but I'm not a doctor). I can't find any other info to confirm this, but perhaps if someone knows for certain, the section should be updated. A lot of prescription and OTC medications come with generic "don't use if you have glaucoma" warnings that do not apply to open-angle glaucoma - this gets to be a problem for those with open-angle glaucoma who have to investigate everything to determine whether it applies to them. Michael Daly 17:03, 11 August 2007 (UTC)
The article mentions research done using UK data. It should be noted that in the UK venlafaxine isn't prescribed by primary care without reference to secondary care, whereas fluoxitine is. Thus, people on venlafaxine have - as the article says - very many more risks associated with suicide attempts or completion. (To get into secondary care you have to be quite ill first, thus you've probably got a history of DSH, maybe attempted suicide, are severely depressed, are isolated, etc.) I don't want to reduce the suicide warnings at all, but I'd like to make the context(primary care use of prozac VS secondary care use of effexor) a bit clearer. Dan Beale-Cocks 14:42, 29 August 2007 (UTC)
Does this mean:
Or does it mean:
? Evercat 01:21, 15 September 2007 (UTC)
"Venlafaxine is not recommended in patients hypersensitive to venlafaxine."
Come on!
unsigned comment —Preceding unsigned comment added by 190.40.0.49 ( talk) 20:26, 18 October 2007 (UTC)
serotonin syndrome is a severe, potentially fatal, condition. The article needs a section about serotonin syndrome, but at the moment there are two sections, and another mention, scattered throughout the article. Should the information be left scattered across two sections, or should it be merged into one section? Dan Beale-Cocks 16:07, 27 October 2007 (UTC)
Venlafaxine has been shown to be effective in treating ADHD in Adults. It is one of the major off label uses of the drug. Does it make sense to include this in the Off-Label-Use section of the article? —Preceding unsigned comment added by 84.185.245.183 ( talk) 22:37, 27 November 2007 (UTC)
I have never heard of venlafaxine being used to treat ADHD of any type in adults or in children. There is no empirical evidence backing such a use, and the side-effect profile and incidence of adverse reactions with this specific drug doesn't lend weight to the idea of using this drug as a first-line treatment for anything. Many patients have increased difficulty concentrating - among other adverse reactions - after the initial phase of anxiety, panic, etc. that accompanies starting venlafaxine therapy, but, it is one of the two most effective labelled ( thymoleptic) antidepressants out there, along with mirtazepine. (Don't get me started on this new "trend" of drug companies attempting to gain extensions on their patents for neuroleptics by getting them labelled as anti-depressants: I can't think of a class of drugs less suited to the task, except, possibly, reserpine.) Even atomoxetine, a drug that is only an NRI, has been found to be next to useless in treating ADHD in adults - and also has some mean side-effects - and within five years of its introduction, has fallen out of common use in favor of the older and more efficacious drugs with more evidence to back them up, and their newer derivatives, such as mixed amphetamine salts, (D)-amphetamine, and lysine-(D)-amphetamine complex, of which the trade name escapes me at the moment (an unbreakable extended-release form of (D)-amphetamine that can not be abused by insufflation or injection). LM Ph.D. Ph.D. D.Pharm.Sci. 75.179.176.190 ( talk) 05:16, 31 May 2010 (UTC)
I have been prescribed this medication as an off-label treatment for Adult ADHD. I asked for Strattera (as my psychiatrist is rabidly anti-stimulant) and it turns out it still isn't available in generic form here, my insurance won't cover the cost of the name brand, & I don't have the $$ to pay for it out of pocket. So, Effexor was her next choice, and I came here again looking to see if there was any other mention of this use of Effexor as ADHD treatment. While it makes some sense, Strattera being an NRI, and Effexor being an SNRI, I'm still not sure that I believe this would be a good treatment...especially since my shrink literally SMIRKS when I bring up my ADHD issues (and tells me to try a gluten-free diet, or not consume sugar or white flour & that should clear it up. Whereas I *HAVE* lived on such a diet, and did so for 2 years...while I felt better overall, it did NOT clear up my ADHD issues!), and I have a feeling my shrink "doesn't believe in ADHD" just as she "doesn't believe in stimulants". I think I need a new shrink. ;) But I did want to mention that, yes, Effexor *IS* sometimes prescribed off-label for ADHD. Kailey elise ( talk) 15:33, 16 December 2010 (UTC)
This is an excellent article in the New York Times by a writer telling of his experiences with Prozac and Effexor. Good stuff.. but it affirms the importance of putting the Effexor Petition link back into this article. This is a professional writer and his material is absolutely on target and of great important in this encyclopedic entry. This is not a drug compendium nor the DSM (which by the way has nothing to do with Statistics). It is an encyclopedic entry about a drug of a group that has much controversy with respect to disclosure of effects by drug companies. I suggest that a review be undertaken to have the effexor petition placed in this section as an issue of freedom of expression and ethical considerations to give voice to 15,000 users who have put their thoughts on line. Others should have tghe right to know about this.. otherwise this entire article is a sham notwithstanding the improvements. 63.250.127.244 ( talk) 00:24, 3 February 2008 (UTC)
Back in the beginning of last year, I went to this exact article and decided that Effexor was the pill for me. I generally enjoy getting information about things I dont know alot about from Wiki. I also engaged many other google hits as well. The other hits contained people describing their horrible withdrawl symptoms, but I discounted them, seeing as how it wasnt mentioned here. In November I went off Effexor. The next week I experienced horrible withdrawl effects. These things, now, are highly cited. There is even a Brain Shivers article which says that Effexor is one of the medications that cause it. Why, then, is there nothing here about them? As an encyclopedia, you do others like myself a great disservice by not mentioning these highly notable effects. You dont have to go into too much detail, just make a list, such as the regular side effects list. Queerbubbles ( talk) 17:24, 26 February 2008 (UTC)
A scan of the discussion page would indicate some distress among those with an opinion about Effexor-Venlafaxine. As a former user I can add another tortured voice.It has been more than 2 years since I last took Effexor and only a few weeks ago I had the strong impression that it is still leaving my system.
The label on this medication states a dosage range from 75 to 150mg, I was quickly titrated to 600mg a day before my anxiety symptoms were finally relieved. My treatment for anxiety which began when I had a series of surgeries and was bedridden for 3 month, first valium, later Paxil and lastly Effexor.
After about 2 years on Effexor I found I was mismanaging my life, could not read, could barely speak, I had been a writer and now could do little more than play video games all day and not very well. Stopping Effexor was extremely difficult but once I got there being off of it was reminiscent of quitting tobacco, there was intense desire for it months later for the first year. My judgment was further impaired by withdrawal, I could not sleep, the writing I produced was written in a state like hysteria and I could not look at it with any critical detachment. What I thought was brilliant was barely intelligible.
The doctors I saw were not educated about this med or its need. Thanks to the American insurance system my doctors and health plan changed annually. Suffice to say the doctor who okayed my stopping Effexor was unaware of the likelihood I would need a replacement SSRI. Many of us who at some level benefit from Effexor should be taking either no more than the label dose or a different SSRI. This is as essential to the health of the patient as insulin is to a diabetic.
My struggle with Effexor made suicide seem more of a choice than ever before in my life. I have known 2 people who went from Effexor to suicide. Is it a statistical lie to say because they were not using Effexor at the time of death Effexor had no part? My strongest suicidal thoughts came a year after I stopped using the drug yet it was still in my mind. 71.245.74.68 ( talk) 13:12, 1 March 2008 (UTC)
Venlafaxine#Suicide Ideation/Risk and Venlafaxine#Physical and Psychological Dependency. I happen to believe that venlafaxine is still hugely overprescribed, and most of the prescriptions for venlafaxine are inappropriate. I tried to make sure that as much as possible (while keeping impartiality) scientific data highlighting its side effects would make it into the article. You are welcome to add more if it is the data from the scientific peer reviewed sources. But also remember to keep the neutral point of view. Paul Gene ( talk) 15:11, 2 March 2008 (UTC)
Comments by Queerbubbles are very much to the point. I found that I had been blocked for "disruption" by expressing my concerns about the ongoing blocking of information such as the Effexor Petition. I am a very polite and respectful person in my dealings with all others, but I do get upset when my views are called a "rant".. i.e. as in rant and rave.. I have asked for a review of Wiki guidelines pertaining to information such as surveys, polls and online petitions. I simply do not agree that an online petition with thousands of people telling of their experience is either unreliable or unverifiable. The sheer preponderance of numbers of personal experience gives weight to common experience. It is not meant as scientific evidence, but it has validity. It would be as reliable as if someone had put out a questionaire on effects with specific questions, and if a researcher had the time, the data in the petition could certainly be extracted into common elements to give a "snapshot" of experience of users. In that regard, I believe it should have stature and I have asked for a review of the guidelines to look at this. I will be appealing my block. Szimonsays ( talk) 06:56, 31 May 2008 (UTC) szimonsays
The article reads as follows: "Venlafaxine hydrochloride is in the phenylthylamine class of modern chemicals, which includes amphetamine, methylendioxymethamphetamine (MDMA), and methamphetamine. This chemical structure likely lends to its activating properties, however some patients find Venlafaxine highly sedating despite its more common stimulatory effects."
I'm not sure why this belongs in an encyclopedia article. And if it should be here then why is it in the Off Label/Investigational uses instead of the chemical structure section? "Phenylthylamine" should be spelled phenylethylamine anyways. There are hundreds and hundreds of chemicals in this class that could be named, so why did this person choose to put venlafaxine solely in the company of drugs of abuse? I don't think it adds anything to the article, and increases the chance that readers will draw incorrect conclusions from the information.
The second sentence refers to the relationship between the chemical's structure and its effects on the CNS. The author does not cite a source for this information. The author also did not provide a reference for the fact that venlafaxine's stimulatory effects are more common. According to the official prescribing information, incidence of insomnia and somnolence were equal (17%), so I'm not sure this could be described as stimulating (unlike the amphetamines mentioned earlier). (Anecdotally, I know one person who complains of great fatigue from this medication.)
I would change this but unfortunately don't have the time to do so. I recommend moving this to the Chemical structure section and removing the references to other phenylethylamines, if it is to be kept at all. -- Navicular ( talk) 14:48, 17 March 2008 (UTC)
It is mentioned in the article that venlafaxine allows dopamine to bind with D2 receptors. Are there other, possibly stronger, chemicals that do this? 914ian915 ( talk) 22:01, 28 July 2008 (UTC)
No I haven't read the article in full, the article discussion in full and nor do I have the time right now. However seeing as wikipedia holds a fairly high search engine weighting and is often the choice for many people seeking information due to it's accessibility and organisatio of articles it is the responsibility, in my opinion, that wikipedia editor's have a responsibility to cover the events of Andrea Yates and link them properly. The drug mentioned in this article played a role with the Andrea Yates events and the Homicidal warning on the Efexor label should be mentioned and indeed have it's own section in this article. Although this is only my opinion on the matter and a wikipedia veteran should look over it please.
Here is the wikipedia article concerning Andrea Yates http://en.wikipedia.org/wiki/Andrea_Yates
Thankyou. —Preceding unsigned comment added by 121.222.119.67 ( talk) 03:52, 2 September 2008 (UTC)
The statement "although some authors dispute the claim that it inhibits norepinephrine reuptake" used the following citation: http://mbldownloads.com/0408PP_Liang_CME.pdf
I don't see in this article where that claim is disputed. The article even calls Venlafaxine an SNRI:
Therefore, “cleaner” drugs were sought and MAOIs and TCAs were largely replaced by selective serotonin reuptake inhibitors (SSRIs; eg, fluoxetine, paroxetine, sertraline) and serotonin norepinephrine reuptake inhibitors (SNRIs; eg, venlafaxine, duloxetine).
The authors also used venlafaxine as the basis of their research into "triple-reuptake inhibitors". Jwesley 78 14:05, 23 November 2009 (UTC)
DocJames has repeatedly blocked any and all attempts to put the opioid method of action for Venlafaxine at the top of this article. The related opioid Tramadol lists SNRI activity at the top despite Tramadol not being officially classified as an SNRI. Venlafaxine lists opioid methods of action three times in the body but not at all in the top section. DocJames is appealing to Western Medical dogmatic thinking which suggests that only the classified use of a drug needs be mentioned. Perhaps DocJames is unaware that there are other methodologies for medicine besides Western Medicine? Perhaps DocJames is aware that not only doctors interact with medications but patients do as well? Why can't patients edit Wikipedia? Maybe patient input is important? Why are these (non-medical) editors being blocked?
The debate... DocJames is lording his medical degree over the rest of us (as advertised on his wiki page). If his medical training is so good (he's an emerg doc, according to wiki page), let him debate the issue publicly and not hide behind repeated bans of my account.
Debate question: Codeine and Morphine differ by 1 carbon atom. The extra carbon of Codeine is demethylated in the liver. This extra processing step makes codeine the 'weaker' opioid because it is less immediately bioavailable. Note that I was able to provide a clear and concise biochemical explanation as to the difference between Codeine and Morphine.
Tramadol and Venlafaxine also differ by 1 carbon atom. What is the exact biochemical explanation (like the one I provided for Codeine/Morphine) which explains why Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(p.s. here's why this debate matters: https://www.ncbi.nlm.nih.gov/pubmed/31637686 ) — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:C8B4:976A:437B:B56 ( talk) 07:03, 23 January 2020 (UTC)
Answer me here DocJames, stop hiding behind user bans. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:C8B4:976A:437B:B56 ( talk) 06:50, 23 January 2020 (UTC)
Poor resources? https://books.google.ca/books?id=sEFyDwAAQBAJ&pg=PA73&dq=venlafaxine+opioid&hl=en&sa=X&ved=0ahUKEwiFvJWS4_fmAhVsp1kKHUE1DZkQ6AEIKTAA#v=onepage&q=venlafaxine%20opioid&f=false A textbook?
Literature Geek: Venlafaxine and Tramadol differ by only one carbon atom. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
EveryoneElse: Notice that I've received a non answer to my question (Venlafaxine vs Tramadol) This will occur over and over again with pretentious Wikipeia editors who know nothing about nothing. Will anyone answer my question? If you can't you're injuring patients by concealing Venlafaxine's opioid method of action. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 02:15, 24 January 2020 (UTC)
"The antinociceptive properties of venlafaine and mirtazapine in mice have been attributed to opioid receptor activation with vanlafaxine's effects mediated via MOP (mu1 opioid), KOP and DOP"
Page 73
"OPIOID RECEPTOR ACTIVATION" That's it! You can't argue further. A textbook lists venlafaxine as working via opioid receptor activation, not indirectly, not downstream... opioid receptor activation. That's an opioid. Period. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:22, 24 January 2020 (UTC)
>> Drugs work like keys in a lock, Absolutely false. Any nitrogen center 2 or 3 atoms away from a phenol group will likely indicate opioid activity. Don't trust me. Google H.H. Hennies... the inventor of Tramadol. It's his quote You absolutely did not answer my debate question. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:25, 24 January 2020 (UTC)
https://www.researchgate.net/publication/20306198_Receptor_binding_analgesic_and_antitussive_potency_of_tramadol_and_other_selected_opioids page 877, first line..
"Despite the ample variability in the structure of opioids, most compounds that behave as narcotic analgesics contain an aromatic ring system spaced from a basic nitrogen center by a group of 2 or 3 atoms..."
Not lock and key. False. Please stop editting articles you don't know anything about. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:36, 24 January 2020 (UTC)
I have provided a source for LiteratureGeek which flat out says that Venlafaxine works by OPIOID RECPTOR ACTIVATION. LiteratureGeek is doing what all wiki editors do, engage in semantic battles when they've lost on logical bases.
LiteratureGeek says drugs are lock and key. I blew that out of the water (see above). Then he said I didn't have a good source... I blew that out of the water (see above). He's now Bill Clintoning and saying that Venlafaxine goes to the opioid receptors but perhaps it doesn't inhale. I will engage in no more conversation with LiteratureGeek because he isn't engaging in debate... he's engaging in "I'm right, you're wrong".
The question remains: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structurally similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both? If you can't answer, don't answer, keep quiet. Lesson for wikikedia editors, keep your mouths shut, you open them too often and are always in error.
Who will debate me next, someone who edits veterinary pages? — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 04:46, 24 January 2020 (UTC)
LiteratureGeek is making up the rules as he goes along. I've provided a source, a TEXTBOOK!!! [1] Again it says: "OPIOID RECEPTOR ACTIVATION". This is unambiguous. It only means one thing. The fact that it refers to a mouse model is inconsequential. It refers to multiple studies if you had bothered to read it. Not just one mouse study. It is in a Academic Text that says "Opioids are good targets for depression" and this is the chapter about how Effexor(Venlafaxine) is one of them! READ!
By the way, mice studies are how opioids are tested. Is LiteratureGeek going to volunteer for a human opioid study where they dissect his brain after a few weeks of exposure? LiteratureGeek needs to go to the Tramadol page. There he'll discover that it lists Tramadol's SNRI activity right up top. He'll then follow the links and realize that it's the same level of 'proof' or verifiability that I've provided for Venlafaxine being an opioid. Is LiteratureGeek going to remove the SNRI activity from the top of Tramadol because it was done on mice?
The question remains: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structural similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(a) the added carbon of Venlafaxine masks the activity of the phenyl group and hence it doesn't bind
(b) the added carbon of Venlafaxine changes the polarity of the molecule such that it no longer binds
(c) the added carbon of Venlafaxine causes Venlafaxine to mirror a known antigen and is removed by the immune system when close to opioid receptors
(d) the added carbon of Venlafaxine causes a 'folded chair' configuration of the cyclohexane ring and blocks binding.
(e) there is no significant difference between Venlafaxine and Tramadol. Both bind similarly. This wasn't detected due to dogmatic thinking and silo'ed development of both drugs and silo'ed approval and safety measures.
— Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 06:41, 24 January 2020 (UTC)
Observers Note: Literaturegeek won't answer any of my questions but only dictates terms and rules which I utterly ignore. Wikipedia is the encyclopedia that can be editted by anyone... not only when Literaturegeek and DocJames approve. Note the insults. That's typical of wikipedia editors after they are defeated logically and have no legs to stand on.
(Directed at LiteratureGeek only, in retort to his rude comments made to me... I can't walk on a beach, Venlafaxine induced a suicide attempt and then left me fully disabled. F you Literaturegeek for your cute f'ing comments. When your grandmother dies of this poison because doctors give her tapentadol for her broken hip and then venlafaxine for her mood, the double opioid action will make her sick and possibly kill her. Don't blame me when it happens. LiteratureGeek, why don't you go walk into the ocean and take a deep breath. https://www.ncbi.nlm.nih.gov/pubmed/31637686 This is why the debate matters. I mentioned it above LiteratureGeek but you're daft for reading. F you.. f you very very hard.)
LiteratureGeek(who never reads):
1) Examine this book:
https://books.google.ca/books?id=sEFyDwAAQBAJ&pg=PA73&dq=venlafaxine+opioid&hl=en&sa=X&ved=0ahUKEwiFvJWS4_fmAhVsp1kKHUE1DZkQ6AEIKTAA#v=onepage&q=venlafaxine%20opioid&f=false
It is published by Elsevier Academic Press. Is this book a text book?
YES/NO
2) Does this book on page 73 read: "The antinociceptive properties of Venlafaxine ... have been attributed to Opioid Receptor Activation"? YES/NO
3) Is Venlafaxine Prescribed for pain? https://www.mayoclinic.org/pain-medications/art-20045647 https://www.health.harvard.edu/pain/drugs-that-relieve-nerve-pain YES/NO
4) Should all uses and modes of a drug be placed in the article lead where prescribers and patients can see them quickly? YES/NO
5) Does Tramadol list SNRI activity in the article lead, despite it not commonly being prescribed as such? YES/NO
6) Given that Venlafaxine is prescribed for pain, and that mechanism is explained in a textbook, does it not belong in the article lead that Venlafaxine exhibits antinociception via Opioidergic activity? YES/NO
7) For patient safety, to avoid situations like this one: https://www.ncbi.nlm.nih.gov/pubmed/31637686 Don't you want the opioid activity of Venlafaxine front and center? YES/NO
And finally, for ALL EDITORS.
Don't edit this article unless you can answer: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structural similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(a) the added carbon of Venlafaxine masks the activity of the phenyl group and hence it doesn't bind
(b) the added carbon of Venlafaxine changes the polarity of the molecule such that it no longer binds
(c) the added carbon of Venlafaxine causes Venlafaxine to mirror a known antigen and is removed by the immune system when close to opioid receptors
(d) the added carbon of Venlafaxine causes a 'folded chair' configuration of the cyclohexane ring and blocks binding.
(e) there is no significant difference between Venlafaxine and Tramadol. Both bind similarly. This wasn't detected due to dogmatic thinking, silo'ed development of both drugs, silo'ed approval and indadequate safety measures. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:ADFF:E27D:2CEE:47ED ( talk) 01:04, 25 January 2020 (UTC)
Regarding: >>How on earth could one of the most commonly prescribed drugs escape law enforcement agencies attention? Answer: In 1988 (Effexor initial research) the method of opioid activity testing was displacement testing. The methodology is that you administer an opioid of known strength. Subsequently you administer the suspected opioid. If the suspected opioid displaces the known opioid, you know your suspect opioid has a strength greater than that of the known opioid.
Venlafaxine was displacement tested against a Wyeth proprietary opioid known as Ciramadol which has never ever seen the light of day clinically. Ciramadol is a mixed opioid agonist/antagonist. It is also very very similar to Tramadol and Venlafaxine. Chances are Venlafaxine is just 5% less powerful than Ciramadol and hence didn't displace it. Also Ciramadol being a mixed agonist/antagonist makes it a poor choice for opioid displacement testing at all.
The FDA, just like the FAA allows drug companies to self select the materials it presents and typically allows the drug companies to self certify. Since the FDA knows less about medicine than either you or DocJames knows, they said "sure, great, sound like a solid study, where's our fee?"
Tramadol was developed in Germany (Gruenthal) in 1977. It's possible Wyeth chemists knew of it but if they did, Tramadol was NOT scheduled at the time. Tramadol was not introduced to the US market until 1995, two fully years after Venlafaxine(Effexor) was approved. To your original point... it took from 1977 until 2014 for Tramadol to be scheduled. Also to your original point, Codeine is an opioid that isn't used for kicks at parties (commonly) and doesn't get you particularly high. Venlafaxine is available only in extended release (due to the typical short half life of Tramadol and Venlafaxine) and hence doesn't give you a 'buzz'.
Did you know that you can no longer purchase codeine containing pain relievers over the counter here in Canada? Wanna know why? They were causing too many addictions. It doesn't have to be a strong opioid to cause problems.
Since the opioid nature of Venlafaxine was unknown it was originally prescribed for children and considered safe during pregnancy. Huge massive lawsuits compelled the FDA to reverse this decision only after 10's of 1000's of deaths.
You shouldn't be shocked that an opioid has escaped the detection nets. It's common: https://www.nature.com/articles/tp201430 Paxil is also an opioid.
As for no one at all abusing venlafaxine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871746/ http://www.dusunenadamdergisi.org/ing/fArticledetails.aspx?MkID=906 https://journals.lww.com/psychopharmacology/Citation/2019/03000/Venlafaxine_Abuse_in_a_Patient_With_a_History_of.16.aspx https://www.nejm.org/doi/full/10.1056/NEJM200302203480822 https://link.springer.com/article/10.1007/s40278-014-3581-8 https://www.tandfonline.com/doi/abs/10.1080/10550887.2013.849974?scroll=top&needAccess=true&journalCode=wjad20 https://www.researchgate.net/publication/280533116_Venlafaxine_as_the_'baby_ecstasy'_Literature_overview_and_analysis_of_web-based_misusers'_experiences
I realized I rambled on about ciramadol and displacement testing without citing resources. Find the original certification of Venlafaxine on Pubmed for the citations. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:ADFF:E27D:2CEE:47ED ( talk) 04:17, 25 January 2020 (UTC)
Hi. this article says that generic extended-release venlafaxine will not be available in the US until 2010, but I'm looking at my wife's prescription right now and it's generic extended-release venlafaxine (at least that's what it says) and it's July 2009. Did something change in regulations? A lawsuit perhaps? Could someone change this to reflect the new reality? Thanks! 70.105.73.44 ( talk) 03:51, 7 July 2009 (UTC)
After doing some more research I now realize that what my wife has been prescribed as equivalent to Effexor-XR (venlafaxine-ER) is not AB-rated to Effexor-XR [1]. If someone could consider a way to make this clear to the layman that would be directed here by a search engine as he looks for answers, I think that would be great. I was studying the subject because my wife, although on the same dose of venlafaxine-ER as she was Effexor-XR, is having similar side effects to those she would experience if she missed a dose.
Something worth looking in to. We'll have to call the doctor. Anyway. Thanks for pointing me in the right direction! —Preceding unsigned comment added by 70.105.73.44 ( talk) 04:22, 7 July 2009 (UTC)
i haven't been to this article for some time, but glad to see that the reality of the risks of this drug have been put here with the preponderance of studies. The first part of the article doesn't reflect this adequately. 63.250.127.245 ( talk) 01:54, 28 January 2009 (UTC) I have added a comment about the black box warnings as the opening statement is badly misleading and prejudiced to make it seem as if this drug is wonderful and without risk. That is not only disingenous but it is misleading. I suggest that my edit be left in place and if anyhone objects to this, please submit for editorial review. This is a FACT and though i have not put a citation, i am sure all editors know that this is beyond question or argument. it is a FACT.... I found a new website that lists items about SSRI and SSRN's in relation to reported side effects and events in which the group of drugs were named or the specific drug was named .. this has more than a thousand entries.. each which is linked to the actual item for review by readers. this is not a statistical study, but is a factual list of actual articles in media about the drugs...ssristories.com i am not posting this in the references by i do suggest that active editors review this.. as i think it deserves to be in this article about this drug and this group of drugs. I am sure at some point, researchers are going to look at these events as more than coincidental.. There was another mass murder in New York State.. i remember when i was a university student that outrage at the Texas Tower massacre, but we seem to have these events happening with a much greater frequency, and it is not a wild stretch to reflect on whether these drugs are the cause.. 67.208.18.54 ( talk) 19:16, 5 April 2009 (UTC)
The statement that venalfaxine is countraindicated in children and adolescents is not supported by either the references or the data. This is a major error. —Preceding unsigned comment added by 129.255.132.90 ( talk) 17:04, 3 February 2008 (UTC)
I am pretty sure that the black box warnings for this drug do have these contraindications. I believe that was one of the main thrusts of the changes to the usage of this drug and a main point of the black box warnings. I suggest you read the actual script on the Wyeth site.
Szimonsays (
talk)
05:32, 7 June 2008 (UTC)
This section needs to be revised.People editing this article seem to have no understanding on how adverse events are reported and later published. Some of the "rare" adverse events reported for venlafaxine are; menopause, rheumatoid arthritis, cellulitis, tendon rupture and breast enlargement, if one is to mention any of the rare adverse events I feel they need to put it in context.I think it's reasonable to assume that most of these "rare" events are not caused by the medication.Secondly, this article in particular emphasizes the adverse events of this drug and puts undue weight on them.Perhaps mentioning the common adverse events(>5% of treated patients and occurs at twice the rate compared to placebo) would suffice ? -- Tdonner 12:27, 7 December 2006 (UTC)
i added a reference for the mao/serotonine syndrome problem and did minor editing.--- 89.60.228.151 ( talk) 22:36, 24 February 2008 (UTC)
I see another deletion/dilution of the information on the Effexor Petition which is the most exhaustive documentation of the side effects including withdrawal of this drug. If you don't like the composition, edit and revise, but stop deleting this. It is highly relevant to this entry on Wikipedia. People have a right to have knowledge of this that is not minimized or washed down.
- Yeah, there is no difference between "brain attempting to reach neurochemical stability" and "addiction." People simply don't want to take something that is physically addictive so the companies get creative in their wording. see physical dependency. I vote this be changed to reflect that it is in fact, physically addictive.
I agree with these comments. Some of the editors are constantly deleting any reference to this drug being "addictive" and only leaving in Wyeth research both in vitro and animal studies with rather limited application to the actual experience of patients using Effexor. This is supported by some rather narrow perception of what "addiction" means. As this is not a drug compendium and the definition of the term "addiction" is clearly subject to some argument and interpretation, the term "addiction" clearly belongs in the encyclopedic entry for Effexor and is supported by THOUSANDS of users, as well as a number of recognized authorities - the distinction between "physical dependency" and "addiction" is rather a blurred area. One could make distinctions between the impact of addiction on illicit drugs and that of effexor, but clearly patitents who are put on this drug without being advised of serious adverse effects, nor of withdrawal symptoms and are then faced with trying to get off the drug, describe this as being "hooked", "addicted", and "dependent". Leaving this out of the section on physical and psychological dependency is simply ridiculous beyond reason or ethics. Those are are doing this.. STOP..... if you want to argue the issue or provide useful edits that retain clarity, then do so, but stop this nonsense of removing material that is absolutely relevant to this entry.
At medium dosages, venlafaxine blocks the reuptake of norepinephrine as well as serotonin. At about 225 mg/day, venlafaxine blocks the reuptake of serotonin and norepinephrine
Are these two sentences saying the same thing? Ubermonkey 22:33, 22 September 2005 (UTC)
I've been under the impression that one of the common reasons for discontinuation of Venlafaxine in women is anorgasma, caused by delay in the sexual response system. Perhaps this should be listed under common side effects. -Cameron Van Sant 9:11, 12 November 2005 (UTC)
I have commented out this sentence which has to go unless someone comes up with a Wyeth reference for severe discontinuation syndrome:
Please note that this not about the existence of these symptoms but about Wyeth's calling them a "severe discontinuation syndrome". The worst thing I could find in Wyeth's online documentation was: "While these events are generally self-limiting, there have been reports of serious discontinuation symptoms" (see Effexor info for healthcare professionals (USA only)). AvB ÷ talk 13:30, 21 January 2006 (UTC)
Discontinuation of this medication sucks. I get the brain shivers even after missing one dose.-- K8TEK 23:12, 20 April 2006 (UTC)
(First time writing so if this is useless then please delete as appropriate. If I miss just one dose I get a dizzy head-spinning type sensation and feel nauseous. Also I find Myself edgy and unable to stand any slightly uncomfortable situation. This is with or without a knowledge of my missed dose. Gem-Ra! ( talk) 00:04, 5 November 2008 (UTC)
The withdrawal syndrome is fairly well documented, and large numbers of anecdotal reports indicate that it is more common with Venlafaxine than with the SSRIs. It is also treatable by introducing an SSRI medication upon cessation. The paresthesias (electric shocks) are also alleviated by SSRIs, and apparently also by benzodiazepines. Google provides a few references, for example this one and this one, both of which qualify as sources for Wikipedia. However, I very much doubt that Wyeth would emphasise this point in their literature as suggested by the removed line; if anyone has actually seen it on their page, use the Wayback Machine to check that date, and we can source it. Otherwise, it stays out. Zuiram 09:32, 14 November 2006 (UTC)
Dirk is a representative from Effexor. He can't allow people to know this drug is not going to help anyone because he wants money. He is one of those people who values money more than the lives of people. Don't buy in, don't give him what he wants, spit out your Effexor. —Preceding unsigned comment added by 65.79.138.222 ( talk) 05:07, 23 August 2008 (UTC)
If you have direct evidence that Dirk is a representative that should be posted here as it may have impact on his position or not, but if there is no direct evidence, then this is pure speculation, and it verges on defamation to imply his views would be due to this relationship. So, either post it or the comment is worthless. 63.250.127.245 ( talk) 00:28, 22 February 2009 (UTC)
someone removed the link i had placed to the Effexor Petition. There is no reason why this should be removed. This is an honest website with 11,000 signatories, most describing their experiences with this drug. This is an important element of patients saying what happened to them and it should remain here so those who look up this entry can see this perspective. This should not be removed again please without any explanation. I will replace it if it is removed again.. and no one needs to have an editing war. If you have a reason why, state it. We are not in a dictatorship where information is screened by the "truth police".. There is tons of information on side effects, but the petition site is one of the few in which patients tell of their experiences,, THOUSANDS OF PEOPLE.
I ;put the link back and someone has removed it again.. STOP THIS NONSENSE... THAT IS NEARLY 12,000 EFFEXOR USERS WHO DESERVE TO BE RECOGNIZED AND WHOSE EXPERIENCE DESERVES TO BE HERE... STOP REMOVING THE LINK WHOEVER IS DOING THIS...... 12,000 PEOPLE AGAINST ONE... WHOEVER IS REMOVING THE LINK.....
Dirk, as i have commented before, you are doing a disservice to readers by censoring useful and relevant information about this drug. The page on anti-depressants has a section on controversy, and effexor has plenty of controversy on its own .. Readers have a right to know this and not to have one person contantly deleting material added by others that is relevant to the current knowledge about this drug. This is relevant information about this particular drug and readers should have the right to know this specific information aobut this drug. The material i add is not my view, or judgemental, it is information provided by researchers and also by thousands of users... a separate link is fine for the larger material, but this does not preclude paragraphs making this knowledge readily available to the Wikipedia audience who deserve to have this information THERE on the main page for Effexor. Censorship is not part of the wikipedia philosophy except for inappropriate material such as racism. The full story on the SSRI's and SSRN's is not yet done.. Effexor is the riskiest of this group, and this needs to be imparted without blocking reference to the petition, nor of the reality of practices in the prescription of the drug that put people at risk. I am not going to stop ensuring that this information is there.. I suggest the editing war stop so that the appropriate material is there in an appropriate form. Sam
I note that some of the points made require references.. i will find these.. the comment about the user info stating "unpleasant" was in the previous user info.. I replaced that one with a more appropriate user info that is more up-to-date and reflects the side effects in more realistic terms. the note about doctors over-prescribing is from a guideline.. but it may take a bit of time for me to find the actual document.. The issue of whether Effexor is addictive or users are drug dependent is really a distinction of semantics more than anything else.. There are some varying views on the definition of addiction. Many users who have suffered the effects of withdrawal use the term addicted when describing how they view the impact... The term is used in a variety of ways and is perfectly OK in this context as well. I am not changing this for now, but I will be do so when i have reviewed the usage of this term more fully. At that point, i will leave the current descriptions in, but will add the broader perspective of addiction that is used in language and that is necessary in this entry as well. Let the reader make up their own mind about the usage of the term here. I appreciate that we don't get into an editing war again. The final verdict on this drug is still not out yet but the thousands of users speak very loudly to the issue. Sam
Filed in 2004 due to the discontinuation of the drug side effects. www.effexorwar.com which leads to http://www.pcalawfirm.com/
As of 12/10/10, both of these links are dead. —Preceding unsigned comment added by 76.115.191.41 ( talk) 06:14, 11 December 2010 (UTC)
Does anyone know the difference between Effexor and Effexor XR? I have looked extensively on the web and there are two ideas regarding the difference. the first being that it is slightly different formulation. The second is that it is a controlled released drug. Meaning that the drug is absorbed over a longer period of time supposidly giving less side effects. I can not find anything from Wyeth. Any help on this would be much appreciated. -- benjaminevans82 July 2006
From the article:
"At low and medium dosages, venlafaxine inhibits serotonin reuptake alone, similarly to a selective serotonin reuptake inhibitor (SSRI). At higher dosages (from about 225 mg/day), venlafaxine inhibits the reuptake of norepinephrine as well as serotonin. At high dosages (starting around 300 mg/day), it inhibits dopamine reuptake in addition to serotonin and norepinephrine."
Would it be possible to get this subtantiated? I see the claim repeated multiple times on various web sites, but never with proper citations. -- Supergloom 17:45, 20 July 2006 (UTC)
"Preclinical studies have shown that venlafaxine and its active metabolite, O-desmethylvenlafaxine (ODV), are potent inhibitors of neuronal serotonin and norepinephrine reuptake and weak inhibitors of dopamine reuptake."
I have also noted how several web sites claim that venlafaxine affects diffrent neurotransmitters depending on the dosage.I'm almost certain this is not the case however.
Someone asked me via my talk page about venlafaxine dose and how it relates to neurotransmitter levels. He wasn't a registered user, and I'm not even sure this is the article he's referring to, however, here is his question and my response:
Feel free to contact me via my talk page if you need more info. ZZYZX 10:38, 31 August 2006 (UTC)
These are not actually footnotes, but are references. Footnotes will appear at the bottom of a particular page of text in a book or in a scientific paper, but when references are listed at one location at the end of an article, these are not actually footnotes.Can someone advise how to add to this section as the actual references are not visible.I cannot add sources at present time.The requirement to add citations for some items and not for others is rather confusing and arbitrary. There is a lot of material here that is not at all referenced. One could nit-pick and ask that every sentence be referenced and that would be ridiculous.Some information is so well known and often mentioned in literature on anti-depressant drugs,that asking for a citation is redundant, for example, if a person is taking alcohol or other drugs, this comorbidity increases risk when taking an anti-depressant and is on all information sheets for the drug -- this is very well known and hardly requires a citation. I am deleting the request for citations in such cases.
Could you advise on how to add a reference.. The listed footnotes are not actually footnotes. These should be titled References. Footnotes are typically placed at the bottom of the specific page where they are noted by a number, not at the end of an article. I will find the reference to some studies showing that the actual effect on reducing depression by Effexor when compared to placebo is negligible. There has been some amazing work done on placebo effect, in which effects of a drug for Lupus were mimicked by placebo when the patient did not know de facto whether the medicine taken was the drug or the placebo. I am sure this doesn't always work, but rather amazing stuff to read. As I noted above,the comorbidity risk for suicide is very widely known and appears in guidelines for Suicide Prevention, and for treatment of both Bipolar disorder and Borderline Personality Disorder. One of the papers I listed includes this but I don't know how to add to the references as the edit sheet does not list the references (called footnotes, but not actually footnotes, unless my knowledge of the convention is incorrect. I appreciate it if we don't get into editing wars. The material I add is not without support. e.g. section on the word "addiction". An encyclopaedia is not a drug compendium, and therefore information about effects on patients and patient feedback should be as important as strictly clinical material. There is a tendency for drug companies to overemphasize the positive effects and minimize negative effects (e..g. "unpleasant" side effects), therefore the overall entry for a drug should be open to adverse views based on evidence and on opinions of recognized authorities e.g. David Healey, Glenmullen, Breggin as well as a forum such as a petition by users now more than 12,000 strong. Sam
I checked the references for the last cut/slash/replace edit and found these to be not supportive of the script. One of the references actually was based on "perception" of general public and not that of actual users of Effexor. I will keep putting back the correct material in this. I don't know who is doing the cutting, but you are ignoring the experience of more than 12,000 people and who are you to make this distinction that severe withdrawal does not swignify dependency. That is exactly what is meant by physical dependency --- a need for the drug to not feel sick, bad, anxious and the entire host of severe withdrawal symptoms that are well known. Why are you a supporter of effexor???? There are users who benefit from this drug and are ok with being on it forever, probably millions of people, but there is a reality of 12,000 users who have had bad effects and this reality should not bve watered down. Sam
Notwithstanding our respective positions, Best wishes, Sam
Mr. Bungle.. what is this supposed to mean? This is not what severe discontinuation syndrome is about. People have tried to wean themselves off this drug and you want to blame them for "non-compliance"?. You are discounting the real experience of people on this drug with this kind of language? This is not reality. "Often patients recognize the link between noncompliance with their medication and discontinuation symptoms and may describe their experience as dependence or "addiction".[13] Your comments are not grounded in this reference. The word addiction and dependence do not appear in the abstract. Is this a quote from the article or your own filter to the abstract that does not mention either of these words or even comment on dependency. I will wait for your reply. If it is your filter, then it is not an accurate representation of the article. If I don't hear a response, I will delete that section and replace it with another referenced comment that will accurately reflect the literature. Sam
Changing the heading from Physical and Psychological Dependency to Drug Abuse and Dependency is clearly incorrect as the section says nothing about drug abuse. I think both of us should research the term drug dependency to come to an accurate description of what this actually means. I am willing to let go of the term "addiction" except as a comment that users state, and stick with the meaning of drug dependency. Read the section on withdrawal in Wikipedia. It confirms that anti-depressants cause drug dependency. It is a well written piece and deserves a link. Taht is good enough for me. Sam
Re the article I cited: The abstract is a 257 word summary of the article, the actual article is 5000 words and 14 pages long, it can be accessed via ingentaconnect at full text this is subscription only and will cost you to download the pdf (alternatively if there is a university library near you can go down there and download it or make a photocopy). The comments from this paper summaries what is known about discontinuation/withdrawal syndromes and I highly recommend reading it.
I didn't change the heading but changing it back is fine, drug abuse and addiction are traditionally discussed together as most drugs which cause dependency are characterized by compulsive drug-seeking and abuse behaviors. A definition of dependence from the diagnostic and Statistical Manual of Mental Disorders put out by the American Psychiatric Association.
Here is a simplified version: A maladaptive pattern of substance use, leading to clinically significant impairment or distress as manifested by three or more of the following, occurring at any time in the same 12-month period:
In terms of these definitions most antidepressants have no clinically significant potential to cause dependence. Lets do venlafaxine: 1. No, 2. Yes, 3. No, 4. Maybe, 5. No, 6. No, 7. No. As mentioned in the article lots of drugs cause withdrawal effects are not thought of as addictive.
I suggest reading Wikipedia:Footnotes for more information on footnotes and how to use them (you can probably also get an idea just by editing the page and looking at how they are set up, just dive in, if you make a mistake someone will fix it). If David Healey, Glenmullen, or Breggin have published work on the subject then it can be added (with a cite) and there would be absolutely no problem with that. Your personal experience (good or bad) should not cloud your judgment and lead to biased information in an article, we need to remain neutral. I don't work for Wyeth or particularly support effexor, but if it wasn't for me (and others) this article would be one long diatribe against the evils of venlafaxine. There is a large amount of evidence in the medical literature about the benefits of this drug (albeit studies probably supported financially by Wyeth) but even so, no scientist is going to fudge results just to paint a 'rosy' picture of the drug. All drugs have risk and benefits we need to weigh them equally and not over emphasize the negative (or positive). I added the opinion poll as antidepressants and mental illness in general have a stigma about them. Most people on the street already think antidepressants are addictive when generally they are not. The petition reinforces this perspective, I am not comfortable with the petition being mentioned for reasons stated above, but I let it slide as people do have the right to know it exists. I have left in some of your information intact, but I plan on editing it in the future (mainly because you use such emotive language). I could care less what order the external links are in, so go hard on rearranging them. We also seem to have taken over this discussion page, if you want you can move it to mine or your discussion page. Mr Bungle 06:04, 7 October 2006 (UTC)
There is plenty of evidence that the risks of the anti-depressants were largely minimized and there is still major concern that some of these drugs may be causing violent behaviour in some individuals in addition to the increased risk of suicide ideation. This is why any article on an anti-depressant drug must have this information in balance. Everyone has different writing styles. Your edits on the dependency section always try to put attitude about dependency or "addiction" as a prejudice or ignorance of patients. This is not balanced - not at all. We know that effexor does not have the effect of heroin, or cocaine, or amphetamines, but we are talking about physical dependency, and just like nicotine, if a user feels uncomfortable without a certain titer of a drug in their system, or if the effect of not having gthat titer is severe, then the distinction between "dependency" and word "addiction" is really more semantics than actuality. Nictotine dependency or "addiction" is certainly not the same as opiate derivative dependencies, but any smoker will tell you that they are addicted. I think you need to revise your entry in the physical and psychological dependency section as it is just not balanced and it basically minimizes the severity of dependence. I am sure that any user trying to get off effexor will disagree with you from personal experience, and to argue against that is like telling someone that a toothache is in their imagination because the dentist can't find the source. As i have noted elsewhere, the full story on anti-depressants is not out yet. I am glad that you have left some of the advice elements i wrote in the article. These can save lives and need to be there, and if you look at the current sheets on effexor by wyeth and others, these are there in detail. You must also consider that the black box warnings do shift a lot of responsibility to physicians and away from wyeth, but with Wikipedia as a known source of information, there is an ethical responsibility by editors to present the facts and NOT to dilute reality by making it seem as if users' experiences are merely subjective and not real. A recent paper links reduction in suicide rates with start of use of the SSRI anti-depressants, and i have seen concerns published through the APA by particular clinicians of the view that the black box warnings and negative publicity might cause deaths by suicide as patients do not take anti-depressants. This was a rather disingenous positon as it presumes that patients should follow advice of the doctor and not be "frightened" by possible side effects. Healey speaks to how psychiatry has moved more to drugs than to non-drug therapies. There was a tendency among general practictioners prescribing anti-depressants with no advice to patients or families. Once a kid was 16, some doctors did not even consider it necessary to inform families. The black box warnings have changed this dramatically as they place accountabiity on doctors even more than on the drug manufacturer. There is a similar controversy about use of Ritalin - concerns about over-prescription of this drug on the basis of inadequate and shoddy diagnosis, or as a crutch for teachers who do not know how to manage children or youth who may be inherently hyperactive. Diagosis is mostly based on testing that is highly subjective. Taht is not to say that there are not kids with ADHD that benefit from the drug, but many doctors are not even aware of the fact that Ritalin is also a street drug, and kids are getting hurt -- one of the side effects of Ritalin addiction is behaviour that mimics OCD, so kids may be diagnosed with OCD because of doctors not knowing how to detect ritalin addiction (it is snorted like cocaine, and the effect is similar). Mr. Bungle, this is an area in which an editor must be very well informed. One article does not support a fact necessarily. The effexor entry must provide good information to users - and not be merely a "compendium" type of entry. I have said it before, but an encyclopedic entry must give a lay reader balanced information that enables them to understand a subject in a broad context. I left in your opening entry about receptors for opiates, etc., being different than those for effexor, but this hardly answers the question and most lay readers won't even know what you are talking about. Effexor does impact more receptors than the other SSRI's as it is actually a SSRN. What does that mean in terms of effect on the patient.? Perhaps a better lay explanation would be of benefit. I am not expert on neurophysiology though I have perused presentations on the action of various drugs on the CNS. At any rate, the bottom line is that the entry must give balance. We are on the left and right of this right now, but I do believe we can improve the entry and in this do a service to readers. I cannot but recall a famous case about 20 or more years ago in which a particular drug was used for severe cases of acne, but doctors who prescribed it were not aware of one very serious but rare side-effect. That side effect was anaplastic anemia that was untreatable and FATAL. Did not happen very often , but when it did, the cost was unbelievable to a family, to the patient. There were about 300 cases per year in the U.S. When this was revealed more widely, the question then to patients and their famiies was - "is the cure worth the risk?" The drug was then taken off the market. The drug company simply did not put much emphasis on the risk. Mr. Bungle, this is the moral issue in writing about a drug on Wikipedia. The article must be balanced and fair. And there is clear ethical responsibility of editors to do that. WE are lay people mostly, and the entry is not a scientific dissertation, but the material must inform. I will try to learn the citation methodology so i can add these where i can. Please respecxt my entries as I will respect yours. If I disagree, i will post here. and vice versa. I am sure we can make this article better. Sam
I am afraid that I am a novice in messaging in Wikipedia. I do my best to contribute honestly to entries and that is what I have tried to do in the Effexor entry.
It is sad and scary that this article is on the first page of google search results for Effexor. If you are looking for any accurate information about this medication, stay away from this page, and the wikipedia pages of any other psychopharmaceuticals. Many of the people editing Wikipedia are seriosly mentally ill, whether psychotic, delusional, or paranoid. By editing Wikipedia their paranoid delusions, previously shouted on the street to strangers, become respectable.
While there are plenty of reputable people editing Wikipedia, at any given time you have no way of knowing whether the version of the page you are reading is written from the POV of a doctor or an untreated mental patient. It may be reasonably accurate for an hour, then full of misinformation and bias the next. While an article on, say, calculus can usually be considered to be accurate, articles on psych medications tend to attract the genuinly insane- people who have been prescribed these medications and need to warn the world of the evil doctor-conspiracy to control their minds.
This is one case where you really want to stick to the real encyclopedias if you want to be sure to get factual information. -- 72.19.81.122 18:11, 9 October 2006 (UTC)
I had written a long reply to this comment, but lost it, so must make this brief. Wikipedia has been compared to hard copy encyclopaedias and online versions and has been given a good rating with respect to accuracy of entries. I am confident that the vast majority of people who do edits here do their best to contribute useful information. I would never edit an article if i did not have some knowledge to be able to contribute usefully, and i imagine that most people operate like that. The accusations in the above rant are pure nonsense - truly. The article has improved in providing better information to readers. Any reader who has more than a passing interest in the anti-depressant drugs in particular and Effexor specifically can do a search on the net and check some of the information. I am confident that they would find that the added material is relevant and factual.
Wikipedia is generally a fairly useful starting point, which is what an encyclopaedia should be. The psychopharmacology sections, however, are often fairly inaccurate. I do not, however, have a paper encyclopaedia around to compare it with, so I'll refrain from commenting on that. This said, anyone choosing to trust wikipedia (without reading the sources) over their psychiatrist's advice is out of their mind, and hence the majority of the errors and omissions are of little consequence. Zuiram 09:38, 14 November 2006 (UTC)
I agree. Non-experts often hold excessive skepticism for wikipedia articles. When questioned about the accuracy of information on wikipedia, usually they say it is high quality.
The0ther
00:28, 5 December 2006 (UTC)
One of the editors is again diluting comments about addiction regarding this drug. I have read commentary about this issue, that the drug companies prefer to use softer language e.g. severe"discontinuance" effects, rather than severe "withdrawal" effects. The terminology is ridiculous as there is no difference between the two. I have replaced the comment about "addiction" and removed the silly attempt to blame patients.. my goodness, how far can someone go to try to whitewash a real effect!!!!!! Blame the patient!!!! Most of those suffering the effects are people trying to get off the drug, not patients who are refusing to take the drug properly or withdrawing quickly. I have deleted that bit of ridiculous blaming of patients. Szimonsays 01:29, 30 October 2006 (UTC)
Nothing I changed can be remotely construed as "blaming the patient". I have been removing your specious and uncited argument about the differences between effexor and hard drug withdrawl being the result of "semantics". If you can find a reputable source that makes this argument, we can discuss how to integrate it into the article in a logical and relevant manner. However, you have not shown any inclination to do so despite multiple requests. You have been repeatedly told to review WP:NPOV and WP:NOR, which you clearly do not yet understand, and I think your long, emotional, and at times unintelligible rants on this talk page serve to demonstrate that. Skinwalker 02:21, 30 October 2006 (UTC)
I am not experienced at putting down citations. Your one reference to the term "addiction" and your language implying that this is caused due to patients not following instructions without really addressing the factual issue is ridiculous. That is how I construe this, and it is clear to me that you do not understand this and want to soften the impact. It is not the patients who are the problem. Not every comment has a citation, though I don't disagree with certain information requiring clear references, however, the semantics of the word "addiction" is mentioned elsewhere and can be easily be reviewed by readers. Why do you persist in not addressing this and trying to give the impression that the users of effexor do not find this product addictive. They, more than you or me, speak to the experience of using this drug and the devastation of withdrawal (not discontinuance as a softened expression of the effect). I will continue to add my comments .. as they are valid. If you want to research this go ahead, appropriately, please be my guest. But you are writing in a tone that puts the blame on patient behaviour. You talk about patients "recognizing non-compliance" - if you do not see the implication you are living in your own delusions. Here is a patient comment.. READ CAREFULLY PLEASE.. "I have been weaning from this drug for almost a year now, and I still must take 75mg every few days, I wait until I can not stand the sensations: electrical zaps in my head that get worse and worse, until I feel like I can not even walk straight, and the hurkey jerky movememnts are horrible. My physician does not believe me and wants me to let go of the last bit, as if it is all in my head, but it's not, and thankfully I have had some left over from when I switched to cymbalta. I don't know what I will do when I run out. I was suicidal before." You are also not complying by calling my comments "rants" and "unintelligible".. hardly reality. Look at yourself in the mirror first. I will find a link to an article on this concern that was written in 2005. Meanwhile I will be deleting your distortion until you stop deleting my comments. yes, we should find references, and if you are honest about integrity in information you will do the citation on my behalf. The term addiction is not as you would wish to want it to be here. It deserves to be handled here in a way that the average reader has a clear understanding of what this really means.. not a distorted censored meaning that hides reality.. Szimonsays 14:15, 30 October 2006 (UTC) READ WIKIPEDIA ARTICLE ON ADDICTION.. This is my reference, and i have added a link to this article on the subject in the article on Effexor. Let the reader decide because obviously you and I live in different universes of what truth is about. Szimonsays 14:30, 30 October 2006 (UTC)
OK Dirk, sorry if my last edit was choppy. It was morning and I was revising again against a time constriction. I look forward to seeing your balanced edit. I reiterate my point that information must be balanced and not written from a subjective point-of-view. The area of controversy in anti-depressants is such that an editor could find references to support this or that perspective while actually distorting the reality. I believe that this article has improved dramatically in the past few months and now represents a very balanced presentation. This is very important as many people use Wikipedia for information, and I know that edits that try to water down facts are just not honest. Others have expressed this view here in the editing talk, but I have made a personal commitment that the information here is truthful and not a distortion of reality. I met tonight with a young woman who was a former user of this drug, and she told me how it frightened her in its impact on her mental health. That is not to say that the drug does not help many millions of patients, but the risks need to be clearly presented here. Otherwise, the article might as well be a series of links to key articles about the drug, and let the readers decide which is more honest and truthful. Balance in editing is a key factor of what gives Wikipedia its strength. Not one person deleting facts that are supported by links within Wikipedia itself (e.g. the term "addiction".) Thanks again Dirk. I trust you will write something that reflects the truth clearly. Szimonsays 02:01, 31 October 2006 (UTC)
Dirk, if what I just read on addiction in this article is your attempt to find balance, I am sorely and sadly disappointed because it just supports the same narrow view of the definition of addiction that is totally inadquate for this article. I hope not. I will check tomorrow hoping that this is not the case. I am adding a separate comment about the defnitiion of the term "addiction" linking this to the article on addiction in Wikipedia. If you think this is not appropriate, then they better delete that article too. I do hope this wasw not your attempt at balance, because it really still tries to soften the impact of this drug at withdrawal, and uses that sleight of semantics to try to make readers think that this drug is NOT ADDICTIVE. It is clearly addictive by general terminology. this is the actual description in the article on addiction in wikipedia "To wit, pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence);" and this is my point - as well as the fact that users of the drug consider it to be addictive as there is a dependency on it. The edit just does not make that clear statement but continues to try to distort truth. Enough is enough. Dirk, this has to stop. I will leave the references to the other point of view, but my argument is as well supported and deserves to remain. Otherwise the war will not stop because i will not leave this distortion of truth to stand. Szimonsays 02:14, 31 October 2006 (UTC)
someone has again deleted the comment about the Effexor Petition. This is really sad and annoying. I am pasting a reference here to support my edit http://www.cmaj.ca/cgi/content/full/170/4/487?etoc The fact that someone would now remove the very important item about the effexor petition says a lot about the sad corruption of this article to hide reality. That section has 12,000 users who deserve to be known here. Their testimony is reality and it should not be deleted. Whoever is doing this is really a lowlife. Szimonsays 22:05, 31 October 2006 (UTC)
Someone has once again removed the material about the effexor petition. I request that editors determine who is doing this and ask them to desist as this is relevant information that needs to be here. If they persist they should be subjected to sanctions. 66.241.132.98
I have read the guideline Skinwalker... I am pasting here for your information..
"Wikipedia has a neutral point of view, which means we strive for articles that advocate no single point of view. Sometimes this requires representing multiple points of view; presenting each point of view accurately; providing context for any given point of view, so that readers understand whose view the point represents; and presenting no one point of view as "the truth" or "the best view". It means citing verifiable, authoritative sources whenever possible, especially on controversial topics. When a conflict arises as to which version is the most neutral, declare a cool-down period and tag the article as disputed; hammer out details on the talk page and follow dispute resolution." You are violating the guidelines by not allowing a neutral point of view by excluding relevant information. Not all information must be verifiable in the strict context - and the Effexor Petition clearly is in a category that the sheer volume of specific reports of experiences that can be seen to be common across THOUSANDS OF USERS give this information validity by preponderance of numbers to the repeated details. The history of the information about the anti-depressant drugs has been heavily weighted against users, and this is very very well documented. Readers are entitled to know about the Effexor Petition within the article. Stop being a censor when censorship is not needed. My script on this was very balanced and fair. I will ensure that readers are given this relevant material in the body of the article. How many times have you seen a petition now nearing 14,000 (of which some are blank and a very few are junk) in which patients tell of their experiencesa with a drug. This is the power of the openness of the internet, and it is also part of the power of Wikipedia. You demean this by your actions. I think that the information provided by 13,000 people deserves two neutral sentences and you as one individual should not act as a censor for whatever distorted reason you have. Szimonsays
Some recent news seems to show SSRIs to have a much stronger effect in preventing completed suicide. Here is a quotation from the article on eurekalert.org:
individuals taking an SSRI known as fluoxetine had a 48 percent lower risk of suicide (6.7 deaths per 1,000 total years that individuals took the drug) compared with those not taking medication (11 deaths per 1,000 years), while those taking venlafaxine hydrochloride, another SSRI, had a 61 percent increased risk (22.5 suicide deaths per 1,000 total years of medication use)
source: Antidepressants associated with increased risk for suicide attempts, decreased risk for death
The0ther 00:13, 5 December 2006 (UTC)
—The preceding unsigned comment was added by The0ther ( talk • contribs) 00:13, 5 December 2006 (UTC).
The only information in the article currently on patent status is in the intro:
I think the situation is actually fairly complex, but I don't have good references at the moment to write anything better. But here is what I understand the situation to be. The compound itself, venlafaxine, is still patented by Wyeth; the patent expires in mid-2008. Wyeth filed in 1997 for a separate patent on the extended-release form, marketed as Effexor XR, which expires in 2017. However Teva challenged this latter patent; Wyeth's case didn't look too good, so they settled it out of court to avoid having their patent actually overturned. As part of the settlement, Teva was given a license to sell "authorized generic" versions of Effexor beginning in mid-2006, two years before the patent is due to expire. So while it's technically true that "generic venlafaxine is available", it's only available from one specific company as part of an out-of-court settlement—it isn't out of patent yet, and is not available from the full range of generics manufacturers. -- Delirium 12:06, 12 December 2006 (UTC)
I am amazed at how this document has gradually softened and reports in the literature advising that Venlafaxine has the highest risk for suicide ideation are just not represented here at all. The tone of the article suggests rather that the risk is all in distortion of studies, rather than in actuality of findings.
I just have not had time to address this or to compile the references showing this presented by studies. The last study I read gave a factor of at least 2 times risk of suicide ideation - and the group was not selected for those individuals specifically at risk. Healy reported that normal patients without any depression or known risk factors had increase of suicide ideation and there was a case of a young woman in a study of Prozac who actually committed suicide during the study. I just do not believe this article is currently balanced and it does not properly represent the two positions now taken by scientists about this group of drugs nor Venlafaxine that is considered by some to be the most risky of this group for some patients. As noted in the review of the Healy case - a risk factor of 1 in a thousand may seem low for some procedures (for example, for angiograms that factor is considered acceptable when compared to a risk of death by heart attack), however, the number of angiograms performed annually compared to the number of users of SSRI's or SSRN's is miniscule and the risk factor of 1 in a thousand when expanded to millions of users, is huge. It is also clear that most prescribers simply do not follow the recommendations for precautions and care in patient management. This has in fact been reported in studies.
This article needs a careful review and update to balance the information presented, as it is currently weighted in favour of the drug's use with the risks being minimized and studies showing these risks not even being presented here fairly. I am glad that at least some stuff remained in the article, and it was a battle to even keep that stuff in, but I am disappointed how this piece has become so badly distorted. wow talk about misinformation. The Effexor petition is certainly more than just withdrawal effects, but hopefully some readers will use the link and get some real information on user experience.
I will be getting my references together as I find time, and putting more information here with references to put this article back into the realm of reality rather than distortion by exclusion.A fair appraisal presents all arguments fairly until such time that the preponderance of evidence supports information to a point of clarity and balanced reporting. That is certainly not the case here as yet. 66.241.132.98 21:28, 15 January 2007 (UTC)
I was disconcerted to see the FDA equated to Federal Drug Administration. It is not ! The acronym FDA stands for Food and Drug Administration. It controls the pruity of both foods and drugs.
Nwbeeson 17:43, 12 February 2007 (UTC)
Is it time to have a section listing all the various brand names for venlafaxine in use around the world?
International Brand Names
* Depurol® (CL) * Dobupal® (ES) * Efectin® (AT, CZ, HR, HU, PL, RO, SI, YU) * Efexor Depot® (FI, SE) * Efexor XR® (AU, ZA) * Efexor® (AR, AU, BE, BR, CH, CL, CO, CR, CY, DK, DO, EC, EG, FI, GB, GT, HN, ID, IE, IL, IT, JO, KW, LB, LU, MT, MX, NL, NO, NZ, PA, PT, SE, SG, SV, TH, TR) * Effexor Paranova® (DK) * Effexor® (FR, IE) * Effexor® XR (CA) * Elafax® (AR) * Faxine® (IT) * Flavix® (IN) * Norpilen® (CL) * Trevilor® (DE) * Vandral® (DK, ES) * Velafax® (HR) * Venlafaxina Combino Pharm® (ES) * Venlafaxina Dosa® (AR) * Venlafaxina Masterfarm® (ES) * Venlafaxina Ratiopharm® (ES) * Venlafaxine-Apex® (NL) * Venlax® (CL) * Venlor® (IN)
cut and paste from here: Merck.com DanBeale 11:05, 6 March 2007 (UTC)
There's a lot of POV pushing going on in this article. Some people seem to be adding stuff without talking about it first, and others are reverting without checking what they're reverting to.
Is there anyway that the "I don't like it" stuff could be put in a neater section? DanBeale 23:51, 15 March 2007 (UTC)
The common side effects list includes "weight gain". Someone changed this to "loss of appetite" included, but this was reverted as vandalism. I've put it back in, and included "weight gain" too. See these links for the "loss of appetite" claims. Priory 'focus on venlafaxine' netdoctor uk information (taken from the patient information leaflet for venlafaxine in the UK) DanBeale 17:10, 22 March 2007 (UTC)
Venlafaxine is no longer prescribed in primary care in the UK because of the risk of heart problems. This isn't something we've highlighted and is probably lost amongst a vast list of potential side effects. The revised guidance from the mrha (medicine and healthcare products regulatory agency) is here. From December 2004 it's only been prescribed by specialists, and is to be prescribed after SSRIs have failed. The risk is cardiac ventricular arrhythmia. The guidance seems to have been relaxed slightly in 2006. The National Institute for Health and Clinical Excellence has in its depression guidelines the following:
The NICE guidance is how venlafaxine is to be used in the National Health Service and hasn't been revised to take into account the info from the MHRA. We need to put some of this in the article. Secretlondon 20:12, 23 March 2007 (UTC)
Code | Result | |||
---|---|---|---|---|
|{{ User:UBX/Venlafaxine}} |
|
Usage |
-- One Salient Oversight 01:47, 4 May 2007 (UTC)
More emphasis needs to be given to the side affects assocaited with effexor, and more notice need be given to the petition. To those who constantly remove mention of it, I must seriously ask, which do you hold in higher esteem, Wiki's policies on "reliable sources," or people's lives? Like it or not, people use Wiki; that's what it's here for. When it comes to something like drugs, the water need be treated very lightly and carefully. We are dealing with a drug here that currently in excess of 10,000 people claim has ruined their lives. I am sad to say that I can count as 10,001. The things described in that petition are very real, and it deserves much more attention in a supposedly accurate and thorough academic article than a miniature citation near the bottom of the page. When the safety and well being of human beings are at stake, I say that at the very least it mildly supercedes the stringent rituals of Wiki editing. Then again, perhaps I am wrong; but I had no idea that Wiki had joined the hallowed halls of freedom, safety, and democracy as an ideal placed above the value of human life. 209.169.89.240 20:14, 10 May 2007 (UTC)
If 12,000 people using the drug report similar experiences at withdrawal, deleting this from the article is irresponsible. You devalue the personal experiences of users, and the number of users exceeds the number of subjects in most studies. If a scientist took the time to sort the survey input into effects, this would be a powerful "study". This does not mean that the drug is not of value for some people, but when a drug has effect on the brain, the risk of side effects (look at the list in the article) may be very high for some individuals. It is not your job to censor valuable information in this article even if you do not agree with it. Please let the Wikipedia reader have the benefit of the personal experiences of users. Such information provides potential patients insights that they can share with their physicians to determine if they should use this drug. One of the major problems is that most prescribers do not take risks very seriously, and in cases of actual suicide hide behind the defence "the patient had chronic depression and depressed people do kill themselves. Sometimes! not always, and if there is a risk with a drug, this should be communicated to patient and to family.
the petition serves this purpose and is a very valuable resource in this article.. Please do not delete section again. I will reinsert and lodge complaint to mediation if necessary.
anyone with a knowledge of risk of both ssri's and the greater risk with effexor and a bit of common sense would not delete the comment on the effexor petition. Sam B
Dan.. your arguments for censoring (it is not editing really) reference to the effexor petition deserve nothing more than disdain except that your censorship is harmful to those who seek information on wiki. Your notion of "reputable" and "verifiable" as applied to the petition are ridiculous. By your standard every election would be invalid as the voters are not "verifiable" or "reputable".. While there may be some petitioners whose feedback may not be reliable, the sheer preponderance of numbers as well as the fact that the information is of known effects of effexor give the petition weight. It is now nearly 15,000 strong. It is noteworthy that some of the "reputable" sources you give so much weight to have been impuned for distortion of reporting of findings, and false reporting is not unknown in the scientific community. Wiki has recently implemented new software to screen editing by vested interests such as employees 0f firms that may have strong negative reports - an example given is watering down of the oil spill disaster by Exxon. The petition stands by sheer numbers as both "reputable" and also "verifiable". You cannot get 15,000 individuals reporting similar life experiences as a "plot". Get serious!!!!! The petition represents real people giving real experience.. Stop deleting the reference to this in the body of the article. It is inevitable that in time researchers will give a fair appraisal to SSRI's and SSRN's such as effexor both for their positive uses and for caution to prevent tragic deaths. That is why the petition is so important. I have not had the time to add back the reference, but i will do so, and I will lodge a complaint if you persist in deleting relevant information because you don't agree. It does not matter that you do not agree. Your arguments are not valid in any case. If you want balance in that - which has been there many times.. describing what the petition is, and the fact that it is anecdotal, but it is powerful just that same and the 15,000 who wrote their input certainly have the right to be heard here Dan... More rights than your deleting this cause you don't agree.. Sam —The preceding unsigned comment was added by 207.61.84.162 ( talk)
Skinwalker... I do not appreciate your deprecatory statement about my comments as "rants". You are using a classical "ad hominem" argument (i.e. attack the person). Personally, I could care less what you think about my comments. We have disagreed before, and this is what makes democracy - that right of people to express differences. I have read the comments about Wiki policy, and while I still don't agree with this in the context of this subject matter, I will not make any further changes at this time, at least not until I am able to support this in relation to Wiki policies. I am, however, glad that the article has improved significantly. I just read the Effexor Petition again today as this is a dynamic document - and the entries are truly heart-wrenching. I never put any content of the petition in the article as this was not appropriate, but I wanted readers to at least know it existed. I am pasting just one recent entry here in the discussion. " found this petition while trying to research Effexor. I was recently prescribed this drug. My reason for researching was because I started to feel worse depression after starting it - I wanted to know if this was normal. I have taken other antidepressants and have not had these strange feelings before - like I am in a dream, hard to focus, empty. I am scared of going off the meds because of what I've read here. But I will stop taking Effexor - It is not worth the risk. My doctor did not tell me anything about withdrawal or side effects. She seemed all too eager to switch me from Prozac to Effexor. I wondered if the Wyeth-Ayerst sales rep was giving her really cool coffee mugs or something. It's not just the pharmaceutical companies that need to grow an conscience - it's also the doctor's who prescribe them without adequately researching them." I am still of the view that anyone who was researching this drug would appreciate a link to the petition in the article. For those who have actually lost family members to suicide with this drug as a possible trigger, I can assure you they wish that someone had warned them. A similar case some twenty years ago was a drug used as a treatment for severe acne, but one relatively rare side effect was a fatal disease of the blood "anaplastic anemia".. My pharmacist thought this was Accutane but when I checked that is not a side effect. Accutane however, does have very serious side effects and is used as it works so well for acne, but only under very very close supervision and some major restrictions - and is rarely ever prescribed by general practictioners. Well, I have the challenge of seeing in what context a reference to the petition will be permissible in Wikipedia and I am looking forward to a positive resolution of this. 207.61.84.162 23:16, 3 November 2007 (UTC)Sam
From the Wyeth web site:
It goes on to mention elevated IOP as a side effect. It seems to me that this is primarily an angle-closure Glaucoma problem, not a general glaucoma problem (but I'm not a doctor). I can't find any other info to confirm this, but perhaps if someone knows for certain, the section should be updated. A lot of prescription and OTC medications come with generic "don't use if you have glaucoma" warnings that do not apply to open-angle glaucoma - this gets to be a problem for those with open-angle glaucoma who have to investigate everything to determine whether it applies to them. Michael Daly 17:03, 11 August 2007 (UTC)
The article mentions research done using UK data. It should be noted that in the UK venlafaxine isn't prescribed by primary care without reference to secondary care, whereas fluoxitine is. Thus, people on venlafaxine have - as the article says - very many more risks associated with suicide attempts or completion. (To get into secondary care you have to be quite ill first, thus you've probably got a history of DSH, maybe attempted suicide, are severely depressed, are isolated, etc.) I don't want to reduce the suicide warnings at all, but I'd like to make the context(primary care use of prozac VS secondary care use of effexor) a bit clearer. Dan Beale-Cocks 14:42, 29 August 2007 (UTC)
Does this mean:
Or does it mean:
? Evercat 01:21, 15 September 2007 (UTC)
"Venlafaxine is not recommended in patients hypersensitive to venlafaxine."
Come on!
unsigned comment —Preceding unsigned comment added by 190.40.0.49 ( talk) 20:26, 18 October 2007 (UTC)
serotonin syndrome is a severe, potentially fatal, condition. The article needs a section about serotonin syndrome, but at the moment there are two sections, and another mention, scattered throughout the article. Should the information be left scattered across two sections, or should it be merged into one section? Dan Beale-Cocks 16:07, 27 October 2007 (UTC)
Venlafaxine has been shown to be effective in treating ADHD in Adults. It is one of the major off label uses of the drug. Does it make sense to include this in the Off-Label-Use section of the article? —Preceding unsigned comment added by 84.185.245.183 ( talk) 22:37, 27 November 2007 (UTC)
I have never heard of venlafaxine being used to treat ADHD of any type in adults or in children. There is no empirical evidence backing such a use, and the side-effect profile and incidence of adverse reactions with this specific drug doesn't lend weight to the idea of using this drug as a first-line treatment for anything. Many patients have increased difficulty concentrating - among other adverse reactions - after the initial phase of anxiety, panic, etc. that accompanies starting venlafaxine therapy, but, it is one of the two most effective labelled ( thymoleptic) antidepressants out there, along with mirtazepine. (Don't get me started on this new "trend" of drug companies attempting to gain extensions on their patents for neuroleptics by getting them labelled as anti-depressants: I can't think of a class of drugs less suited to the task, except, possibly, reserpine.) Even atomoxetine, a drug that is only an NRI, has been found to be next to useless in treating ADHD in adults - and also has some mean side-effects - and within five years of its introduction, has fallen out of common use in favor of the older and more efficacious drugs with more evidence to back them up, and their newer derivatives, such as mixed amphetamine salts, (D)-amphetamine, and lysine-(D)-amphetamine complex, of which the trade name escapes me at the moment (an unbreakable extended-release form of (D)-amphetamine that can not be abused by insufflation or injection). LM Ph.D. Ph.D. D.Pharm.Sci. 75.179.176.190 ( talk) 05:16, 31 May 2010 (UTC)
I have been prescribed this medication as an off-label treatment for Adult ADHD. I asked for Strattera (as my psychiatrist is rabidly anti-stimulant) and it turns out it still isn't available in generic form here, my insurance won't cover the cost of the name brand, & I don't have the $$ to pay for it out of pocket. So, Effexor was her next choice, and I came here again looking to see if there was any other mention of this use of Effexor as ADHD treatment. While it makes some sense, Strattera being an NRI, and Effexor being an SNRI, I'm still not sure that I believe this would be a good treatment...especially since my shrink literally SMIRKS when I bring up my ADHD issues (and tells me to try a gluten-free diet, or not consume sugar or white flour & that should clear it up. Whereas I *HAVE* lived on such a diet, and did so for 2 years...while I felt better overall, it did NOT clear up my ADHD issues!), and I have a feeling my shrink "doesn't believe in ADHD" just as she "doesn't believe in stimulants". I think I need a new shrink. ;) But I did want to mention that, yes, Effexor *IS* sometimes prescribed off-label for ADHD. Kailey elise ( talk) 15:33, 16 December 2010 (UTC)
This is an excellent article in the New York Times by a writer telling of his experiences with Prozac and Effexor. Good stuff.. but it affirms the importance of putting the Effexor Petition link back into this article. This is a professional writer and his material is absolutely on target and of great important in this encyclopedic entry. This is not a drug compendium nor the DSM (which by the way has nothing to do with Statistics). It is an encyclopedic entry about a drug of a group that has much controversy with respect to disclosure of effects by drug companies. I suggest that a review be undertaken to have the effexor petition placed in this section as an issue of freedom of expression and ethical considerations to give voice to 15,000 users who have put their thoughts on line. Others should have tghe right to know about this.. otherwise this entire article is a sham notwithstanding the improvements. 63.250.127.244 ( talk) 00:24, 3 February 2008 (UTC)
Back in the beginning of last year, I went to this exact article and decided that Effexor was the pill for me. I generally enjoy getting information about things I dont know alot about from Wiki. I also engaged many other google hits as well. The other hits contained people describing their horrible withdrawl symptoms, but I discounted them, seeing as how it wasnt mentioned here. In November I went off Effexor. The next week I experienced horrible withdrawl effects. These things, now, are highly cited. There is even a Brain Shivers article which says that Effexor is one of the medications that cause it. Why, then, is there nothing here about them? As an encyclopedia, you do others like myself a great disservice by not mentioning these highly notable effects. You dont have to go into too much detail, just make a list, such as the regular side effects list. Queerbubbles ( talk) 17:24, 26 February 2008 (UTC)
A scan of the discussion page would indicate some distress among those with an opinion about Effexor-Venlafaxine. As a former user I can add another tortured voice.It has been more than 2 years since I last took Effexor and only a few weeks ago I had the strong impression that it is still leaving my system.
The label on this medication states a dosage range from 75 to 150mg, I was quickly titrated to 600mg a day before my anxiety symptoms were finally relieved. My treatment for anxiety which began when I had a series of surgeries and was bedridden for 3 month, first valium, later Paxil and lastly Effexor.
After about 2 years on Effexor I found I was mismanaging my life, could not read, could barely speak, I had been a writer and now could do little more than play video games all day and not very well. Stopping Effexor was extremely difficult but once I got there being off of it was reminiscent of quitting tobacco, there was intense desire for it months later for the first year. My judgment was further impaired by withdrawal, I could not sleep, the writing I produced was written in a state like hysteria and I could not look at it with any critical detachment. What I thought was brilliant was barely intelligible.
The doctors I saw were not educated about this med or its need. Thanks to the American insurance system my doctors and health plan changed annually. Suffice to say the doctor who okayed my stopping Effexor was unaware of the likelihood I would need a replacement SSRI. Many of us who at some level benefit from Effexor should be taking either no more than the label dose or a different SSRI. This is as essential to the health of the patient as insulin is to a diabetic.
My struggle with Effexor made suicide seem more of a choice than ever before in my life. I have known 2 people who went from Effexor to suicide. Is it a statistical lie to say because they were not using Effexor at the time of death Effexor had no part? My strongest suicidal thoughts came a year after I stopped using the drug yet it was still in my mind. 71.245.74.68 ( talk) 13:12, 1 March 2008 (UTC)
Venlafaxine#Suicide Ideation/Risk and Venlafaxine#Physical and Psychological Dependency. I happen to believe that venlafaxine is still hugely overprescribed, and most of the prescriptions for venlafaxine are inappropriate. I tried to make sure that as much as possible (while keeping impartiality) scientific data highlighting its side effects would make it into the article. You are welcome to add more if it is the data from the scientific peer reviewed sources. But also remember to keep the neutral point of view. Paul Gene ( talk) 15:11, 2 March 2008 (UTC)
Comments by Queerbubbles are very much to the point. I found that I had been blocked for "disruption" by expressing my concerns about the ongoing blocking of information such as the Effexor Petition. I am a very polite and respectful person in my dealings with all others, but I do get upset when my views are called a "rant".. i.e. as in rant and rave.. I have asked for a review of Wiki guidelines pertaining to information such as surveys, polls and online petitions. I simply do not agree that an online petition with thousands of people telling of their experience is either unreliable or unverifiable. The sheer preponderance of numbers of personal experience gives weight to common experience. It is not meant as scientific evidence, but it has validity. It would be as reliable as if someone had put out a questionaire on effects with specific questions, and if a researcher had the time, the data in the petition could certainly be extracted into common elements to give a "snapshot" of experience of users. In that regard, I believe it should have stature and I have asked for a review of the guidelines to look at this. I will be appealing my block. Szimonsays ( talk) 06:56, 31 May 2008 (UTC) szimonsays
The article reads as follows: "Venlafaxine hydrochloride is in the phenylthylamine class of modern chemicals, which includes amphetamine, methylendioxymethamphetamine (MDMA), and methamphetamine. This chemical structure likely lends to its activating properties, however some patients find Venlafaxine highly sedating despite its more common stimulatory effects."
I'm not sure why this belongs in an encyclopedia article. And if it should be here then why is it in the Off Label/Investigational uses instead of the chemical structure section? "Phenylthylamine" should be spelled phenylethylamine anyways. There are hundreds and hundreds of chemicals in this class that could be named, so why did this person choose to put venlafaxine solely in the company of drugs of abuse? I don't think it adds anything to the article, and increases the chance that readers will draw incorrect conclusions from the information.
The second sentence refers to the relationship between the chemical's structure and its effects on the CNS. The author does not cite a source for this information. The author also did not provide a reference for the fact that venlafaxine's stimulatory effects are more common. According to the official prescribing information, incidence of insomnia and somnolence were equal (17%), so I'm not sure this could be described as stimulating (unlike the amphetamines mentioned earlier). (Anecdotally, I know one person who complains of great fatigue from this medication.)
I would change this but unfortunately don't have the time to do so. I recommend moving this to the Chemical structure section and removing the references to other phenylethylamines, if it is to be kept at all. -- Navicular ( talk) 14:48, 17 March 2008 (UTC)
It is mentioned in the article that venlafaxine allows dopamine to bind with D2 receptors. Are there other, possibly stronger, chemicals that do this? 914ian915 ( talk) 22:01, 28 July 2008 (UTC)
No I haven't read the article in full, the article discussion in full and nor do I have the time right now. However seeing as wikipedia holds a fairly high search engine weighting and is often the choice for many people seeking information due to it's accessibility and organisatio of articles it is the responsibility, in my opinion, that wikipedia editor's have a responsibility to cover the events of Andrea Yates and link them properly. The drug mentioned in this article played a role with the Andrea Yates events and the Homicidal warning on the Efexor label should be mentioned and indeed have it's own section in this article. Although this is only my opinion on the matter and a wikipedia veteran should look over it please.
Here is the wikipedia article concerning Andrea Yates http://en.wikipedia.org/wiki/Andrea_Yates
Thankyou. —Preceding unsigned comment added by 121.222.119.67 ( talk) 03:52, 2 September 2008 (UTC)
The statement "although some authors dispute the claim that it inhibits norepinephrine reuptake" used the following citation: http://mbldownloads.com/0408PP_Liang_CME.pdf
I don't see in this article where that claim is disputed. The article even calls Venlafaxine an SNRI:
Therefore, “cleaner” drugs were sought and MAOIs and TCAs were largely replaced by selective serotonin reuptake inhibitors (SSRIs; eg, fluoxetine, paroxetine, sertraline) and serotonin norepinephrine reuptake inhibitors (SNRIs; eg, venlafaxine, duloxetine).
The authors also used venlafaxine as the basis of their research into "triple-reuptake inhibitors". Jwesley 78 14:05, 23 November 2009 (UTC)
DocJames has repeatedly blocked any and all attempts to put the opioid method of action for Venlafaxine at the top of this article. The related opioid Tramadol lists SNRI activity at the top despite Tramadol not being officially classified as an SNRI. Venlafaxine lists opioid methods of action three times in the body but not at all in the top section. DocJames is appealing to Western Medical dogmatic thinking which suggests that only the classified use of a drug needs be mentioned. Perhaps DocJames is unaware that there are other methodologies for medicine besides Western Medicine? Perhaps DocJames is aware that not only doctors interact with medications but patients do as well? Why can't patients edit Wikipedia? Maybe patient input is important? Why are these (non-medical) editors being blocked?
The debate... DocJames is lording his medical degree over the rest of us (as advertised on his wiki page). If his medical training is so good (he's an emerg doc, according to wiki page), let him debate the issue publicly and not hide behind repeated bans of my account.
Debate question: Codeine and Morphine differ by 1 carbon atom. The extra carbon of Codeine is demethylated in the liver. This extra processing step makes codeine the 'weaker' opioid because it is less immediately bioavailable. Note that I was able to provide a clear and concise biochemical explanation as to the difference between Codeine and Morphine.
Tramadol and Venlafaxine also differ by 1 carbon atom. What is the exact biochemical explanation (like the one I provided for Codeine/Morphine) which explains why Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(p.s. here's why this debate matters: https://www.ncbi.nlm.nih.gov/pubmed/31637686 ) — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:C8B4:976A:437B:B56 ( talk) 07:03, 23 January 2020 (UTC)
Answer me here DocJames, stop hiding behind user bans. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:C8B4:976A:437B:B56 ( talk) 06:50, 23 January 2020 (UTC)
Poor resources? https://books.google.ca/books?id=sEFyDwAAQBAJ&pg=PA73&dq=venlafaxine+opioid&hl=en&sa=X&ved=0ahUKEwiFvJWS4_fmAhVsp1kKHUE1DZkQ6AEIKTAA#v=onepage&q=venlafaxine%20opioid&f=false A textbook?
Literature Geek: Venlafaxine and Tramadol differ by only one carbon atom. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
EveryoneElse: Notice that I've received a non answer to my question (Venlafaxine vs Tramadol) This will occur over and over again with pretentious Wikipeia editors who know nothing about nothing. Will anyone answer my question? If you can't you're injuring patients by concealing Venlafaxine's opioid method of action. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 02:15, 24 January 2020 (UTC)
"The antinociceptive properties of venlafaine and mirtazapine in mice have been attributed to opioid receptor activation with vanlafaxine's effects mediated via MOP (mu1 opioid), KOP and DOP"
Page 73
"OPIOID RECEPTOR ACTIVATION" That's it! You can't argue further. A textbook lists venlafaxine as working via opioid receptor activation, not indirectly, not downstream... opioid receptor activation. That's an opioid. Period. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:22, 24 January 2020 (UTC)
>> Drugs work like keys in a lock, Absolutely false. Any nitrogen center 2 or 3 atoms away from a phenol group will likely indicate opioid activity. Don't trust me. Google H.H. Hennies... the inventor of Tramadol. It's his quote You absolutely did not answer my debate question. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:25, 24 January 2020 (UTC)
https://www.researchgate.net/publication/20306198_Receptor_binding_analgesic_and_antitussive_potency_of_tramadol_and_other_selected_opioids page 877, first line..
"Despite the ample variability in the structure of opioids, most compounds that behave as narcotic analgesics contain an aromatic ring system spaced from a basic nitrogen center by a group of 2 or 3 atoms..."
Not lock and key. False. Please stop editting articles you don't know anything about. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 03:36, 24 January 2020 (UTC)
I have provided a source for LiteratureGeek which flat out says that Venlafaxine works by OPIOID RECPTOR ACTIVATION. LiteratureGeek is doing what all wiki editors do, engage in semantic battles when they've lost on logical bases.
LiteratureGeek says drugs are lock and key. I blew that out of the water (see above). Then he said I didn't have a good source... I blew that out of the water (see above). He's now Bill Clintoning and saying that Venlafaxine goes to the opioid receptors but perhaps it doesn't inhale. I will engage in no more conversation with LiteratureGeek because he isn't engaging in debate... he's engaging in "I'm right, you're wrong".
The question remains: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structurally similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both? If you can't answer, don't answer, keep quiet. Lesson for wikikedia editors, keep your mouths shut, you open them too often and are always in error.
Who will debate me next, someone who edits veterinary pages? — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 04:46, 24 January 2020 (UTC)
LiteratureGeek is making up the rules as he goes along. I've provided a source, a TEXTBOOK!!! [1] Again it says: "OPIOID RECEPTOR ACTIVATION". This is unambiguous. It only means one thing. The fact that it refers to a mouse model is inconsequential. It refers to multiple studies if you had bothered to read it. Not just one mouse study. It is in a Academic Text that says "Opioids are good targets for depression" and this is the chapter about how Effexor(Venlafaxine) is one of them! READ!
By the way, mice studies are how opioids are tested. Is LiteratureGeek going to volunteer for a human opioid study where they dissect his brain after a few weeks of exposure? LiteratureGeek needs to go to the Tramadol page. There he'll discover that it lists Tramadol's SNRI activity right up top. He'll then follow the links and realize that it's the same level of 'proof' or verifiability that I've provided for Venlafaxine being an opioid. Is LiteratureGeek going to remove the SNRI activity from the top of Tramadol because it was done on mice?
The question remains: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structural similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(a) the added carbon of Venlafaxine masks the activity of the phenyl group and hence it doesn't bind
(b) the added carbon of Venlafaxine changes the polarity of the molecule such that it no longer binds
(c) the added carbon of Venlafaxine causes Venlafaxine to mirror a known antigen and is removed by the immune system when close to opioid receptors
(d) the added carbon of Venlafaxine causes a 'folded chair' configuration of the cyclohexane ring and blocks binding.
(e) there is no significant difference between Venlafaxine and Tramadol. Both bind similarly. This wasn't detected due to dogmatic thinking and silo'ed development of both drugs and silo'ed approval and safety measures.
— Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:247F:54CF:D553:4D05 ( talk) 06:41, 24 January 2020 (UTC)
Observers Note: Literaturegeek won't answer any of my questions but only dictates terms and rules which I utterly ignore. Wikipedia is the encyclopedia that can be editted by anyone... not only when Literaturegeek and DocJames approve. Note the insults. That's typical of wikipedia editors after they are defeated logically and have no legs to stand on.
(Directed at LiteratureGeek only, in retort to his rude comments made to me... I can't walk on a beach, Venlafaxine induced a suicide attempt and then left me fully disabled. F you Literaturegeek for your cute f'ing comments. When your grandmother dies of this poison because doctors give her tapentadol for her broken hip and then venlafaxine for her mood, the double opioid action will make her sick and possibly kill her. Don't blame me when it happens. LiteratureGeek, why don't you go walk into the ocean and take a deep breath. https://www.ncbi.nlm.nih.gov/pubmed/31637686 This is why the debate matters. I mentioned it above LiteratureGeek but you're daft for reading. F you.. f you very very hard.)
LiteratureGeek(who never reads):
1) Examine this book:
https://books.google.ca/books?id=sEFyDwAAQBAJ&pg=PA73&dq=venlafaxine+opioid&hl=en&sa=X&ved=0ahUKEwiFvJWS4_fmAhVsp1kKHUE1DZkQ6AEIKTAA#v=onepage&q=venlafaxine%20opioid&f=false
It is published by Elsevier Academic Press. Is this book a text book?
YES/NO
2) Does this book on page 73 read: "The antinociceptive properties of Venlafaxine ... have been attributed to Opioid Receptor Activation"? YES/NO
3) Is Venlafaxine Prescribed for pain? https://www.mayoclinic.org/pain-medications/art-20045647 https://www.health.harvard.edu/pain/drugs-that-relieve-nerve-pain YES/NO
4) Should all uses and modes of a drug be placed in the article lead where prescribers and patients can see them quickly? YES/NO
5) Does Tramadol list SNRI activity in the article lead, despite it not commonly being prescribed as such? YES/NO
6) Given that Venlafaxine is prescribed for pain, and that mechanism is explained in a textbook, does it not belong in the article lead that Venlafaxine exhibits antinociception via Opioidergic activity? YES/NO
7) For patient safety, to avoid situations like this one: https://www.ncbi.nlm.nih.gov/pubmed/31637686 Don't you want the opioid activity of Venlafaxine front and center? YES/NO
And finally, for ALL EDITORS.
Don't edit this article unless you can answer: Venlafaxine and Tramadol differ by one carbon atom only. Thanks to LiteratureGeek we know that structural similarity is hugely important in opioid activiy. What is the exact biochemical reason that Venlafaxine is neither a mu1 binding opioid nor an NMDA antagonist whereas Tramadol is both?
(a) the added carbon of Venlafaxine masks the activity of the phenyl group and hence it doesn't bind
(b) the added carbon of Venlafaxine changes the polarity of the molecule such that it no longer binds
(c) the added carbon of Venlafaxine causes Venlafaxine to mirror a known antigen and is removed by the immune system when close to opioid receptors
(d) the added carbon of Venlafaxine causes a 'folded chair' configuration of the cyclohexane ring and blocks binding.
(e) there is no significant difference between Venlafaxine and Tramadol. Both bind similarly. This wasn't detected due to dogmatic thinking, silo'ed development of both drugs, silo'ed approval and indadequate safety measures. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:ADFF:E27D:2CEE:47ED ( talk) 01:04, 25 January 2020 (UTC)
Regarding: >>How on earth could one of the most commonly prescribed drugs escape law enforcement agencies attention? Answer: In 1988 (Effexor initial research) the method of opioid activity testing was displacement testing. The methodology is that you administer an opioid of known strength. Subsequently you administer the suspected opioid. If the suspected opioid displaces the known opioid, you know your suspect opioid has a strength greater than that of the known opioid.
Venlafaxine was displacement tested against a Wyeth proprietary opioid known as Ciramadol which has never ever seen the light of day clinically. Ciramadol is a mixed opioid agonist/antagonist. It is also very very similar to Tramadol and Venlafaxine. Chances are Venlafaxine is just 5% less powerful than Ciramadol and hence didn't displace it. Also Ciramadol being a mixed agonist/antagonist makes it a poor choice for opioid displacement testing at all.
The FDA, just like the FAA allows drug companies to self select the materials it presents and typically allows the drug companies to self certify. Since the FDA knows less about medicine than either you or DocJames knows, they said "sure, great, sound like a solid study, where's our fee?"
Tramadol was developed in Germany (Gruenthal) in 1977. It's possible Wyeth chemists knew of it but if they did, Tramadol was NOT scheduled at the time. Tramadol was not introduced to the US market until 1995, two fully years after Venlafaxine(Effexor) was approved. To your original point... it took from 1977 until 2014 for Tramadol to be scheduled. Also to your original point, Codeine is an opioid that isn't used for kicks at parties (commonly) and doesn't get you particularly high. Venlafaxine is available only in extended release (due to the typical short half life of Tramadol and Venlafaxine) and hence doesn't give you a 'buzz'.
Did you know that you can no longer purchase codeine containing pain relievers over the counter here in Canada? Wanna know why? They were causing too many addictions. It doesn't have to be a strong opioid to cause problems.
Since the opioid nature of Venlafaxine was unknown it was originally prescribed for children and considered safe during pregnancy. Huge massive lawsuits compelled the FDA to reverse this decision only after 10's of 1000's of deaths.
You shouldn't be shocked that an opioid has escaped the detection nets. It's common: https://www.nature.com/articles/tp201430 Paxil is also an opioid.
As for no one at all abusing venlafaxine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871746/ http://www.dusunenadamdergisi.org/ing/fArticledetails.aspx?MkID=906 https://journals.lww.com/psychopharmacology/Citation/2019/03000/Venlafaxine_Abuse_in_a_Patient_With_a_History_of.16.aspx https://www.nejm.org/doi/full/10.1056/NEJM200302203480822 https://link.springer.com/article/10.1007/s40278-014-3581-8 https://www.tandfonline.com/doi/abs/10.1080/10550887.2013.849974?scroll=top&needAccess=true&journalCode=wjad20 https://www.researchgate.net/publication/280533116_Venlafaxine_as_the_'baby_ecstasy'_Literature_overview_and_analysis_of_web-based_misusers'_experiences
I realized I rambled on about ciramadol and displacement testing without citing resources. Find the original certification of Venlafaxine on Pubmed for the citations. — Preceding unsigned comment added by 2607:FEA8:3CA0:3CD:ADFF:E27D:2CEE:47ED ( talk) 04:17, 25 January 2020 (UTC)