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.