In late 2005, a warning was added to the 47-page labeling and one-page package insert for the widely employed antidepressant Effexor (venlafaxine hydrochloride), indicating risk of murderous thoughts, or “homicidal ideation,” as a rare adverse event. The issue being that Wyeth, the drug’s maker, had not alerted prescribing physicians to the addition. As a result many doctors, and depressed patients under their care, were not fully informed and aware of all potential side effects. But for perspective, unlike an adverse reaction
, an adverse event
“may or may not be causally related to treatment.” Also, the FDA defines rare
as likely to occur in fewer than 1 in 1,000 people. And importantly, venlafaxine may have special “multi-purpose” mood-plus-pain-relief benefits for Fibromyalgia patients, who are diagnosed with depression at a higher rate than the population overall. The clinical study “Venlafaxine Treatment of Fibromyalgia,” by Kemal Sayar, MD, et al., published in the November 2003 issue of the Annals of Pharmacology
, reports that venlafaxine therapy administered to Fibromyalgia patients diagnosed with depression produced “significant” improvement in depression and anxiety as well as pain intensity. The conclusion: “Blockade of both norepinephrine and serotonin reuptake might be more effective than blockade of either neurotransmitter alone in the treatment of Fibromyalgia.” Venlafaxine is also typically a “second-round” drug prescribed when SSRI antidepressants – which block the reuptake of (concentrate) the brain-cell impulse stimulator serotonin – are not well tolerated or fail to relieve depression.* What does this mean for you? 1. No matter the potential benefits of a medication, doctors, patients, and their families deserve to be fully informed and aware of potential drug side effects. 2. Despite the short six to eight minutes physicians typically have to spend in a single patient visit, you need to be proactive in ensuring that you learn about and discuss drug side effects and interactions.
3. It is always a good practice to schedule a free drug consultation with a pharmacist at your local pharmacy or medical center. These professionals have ready access to the latest available facts and databases on drug side effects – and any known interactions with both other prescription drugs and dietary or herbal supplements.
* “Bupropion-SR, Sertraline, or Venlafaxine-XR after Failure of SSRIs for Depression,” by A. John Rush, MD, et al., New England Journal of Medicine, March 23, 2006.