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Venlafaxine : ウィキペディア英語版
Venlafaxine


Venlafaxine — brand names: ''Effexor'', ''Effexor XR'', ''Lanvexin'', ''Viepax'' and ''Trevilor'' — is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. This means it increases the concentrations of the neurotransmitters serotonin and norepinephrine in the body and the brain. First introduced by Wyeth in 1993, now marketed by Pfizer, it is licensed for the treatment of major depressive disorder (MDD), generalised anxiety disorder (GAD), panic disorder and social phobia.
Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis has shown venlafaxine, alongside mirtazapine, escitalopram and sertraline was significantly more efficacious.〔http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60046-5/fulltext〕
Remission rates (defined as a HAM-D score of 7 or less) were 58% for venlafaxine plus mirtazapine.〔http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2009.09020186〕 This combination is known by the medical slang term "California rocket fuel".
The rate of life-threatening or lethal outcomes for suicidal overdoses of venlafaxine is lower than for the TCAs, MAOIs and bupropion and comparable to several of the SSRIs. It is metabolised in the body into another antidepressant drug called desvenlafaxine (''O''-desmethylvenlafaxine) which is also sold as an antidepressant, under the brand name ''Pristiq''.
Both venlafaxine and paroxetine have been linked to the most severe discontinuation symptoms.
In combination with an antipsychotic medicine aripiprazole, better results in treatment resistant depression in older adults have been demonstrated.〔http://medicalxpress.com/news/2015-09-two-drug-combo-older-adults-hard-to-treat.html〕
In 2007, venlafaxine was the sixth most commonly prescribed antidepressant on the U.S. retail market, with 17.2 million prescriptions.〔The number of prescriptions was calculated as the total of prescriptions for the corresponding generic and brand-name drugs using data from the charts for generic and brand-name drugs. 〕
==Medical uses==
Venlafaxine is used primarily for the treatment of depression, general anxiety disorder, social phobia, panic disorder and vasomotor symptoms.〔(【引用サイトリンク】url=http://www.drugs.com/monograph/venlafaxine-hydrochloride.html )〕 At low doses (<150 mg/day), it acts only on serotonergic transmission. At moderate doses (>150 mg/day), it acts on serotonergic and noradrenergic systems, whereas at high doses (>300 mg/day), it also affects dopaminergic neurotransmission.
Many doctors were starting to prescribe venlafaxine "off label" for the treatment of diabetic neuropathy (in a similar manner to duloxetine) and migraine prophylaxis (in some people, however, venlafaxine can exacerbate or cause migraines). Studies have shown venlafaxine's effectiveness for these conditions, although agents that are marketed for this purpose (like pregabalin or duloxetine) are likely preferred. It has also been found to reduce the severity of 'hot flashes' in menopausal women and men on hormonal therapy for the treatment of prostate cancer.
Due to its action on both the serotoninergic and adrenergic systems, venlafaxine is also used as a treatment to reduce episodes of cataplexy, a form of muscle weakness, in patients with the sleep disorder narcolepsy. Some open-label and three double-blind studies have suggested the efficacy of venlafaxine in the treatment of attention deficit-hyperactivity disorder (ADHD). Likewise well-designed clinical trials have found possible efficacy in those with post-traumatic stress disorder (PTSD).

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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