Venlafaxine

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Also indexed as:

Effexor

Venlafaxine is a drug used to treat depression. It is unrelated to other drugs used to treat depression.

Herbs

Summary of Interactions for Venlafaxine

Depletion or interference	None known
Adverse interaction	5-Hydroxytryptophan (5-HTP)* L-tryptophan* Sour date nut (Ziziphus jujube) St. John's wort*
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known
Other (see text)	Sodium

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

5-Hydroxytryptophan (5-HTP) and L-tryptophan

Venlafaxine, a potent serotonin reuptake inhibitor, has been associated with several cases of serotonin syndrome.^{1, 2, 3, 4} 5-HTP and L-tryptophan are converted to serotonin in the brain, and taking them with venlafaxine may increase venlafaxine-induced side effects. While no interactions with venlafaxine and 5-HTP or L-tryptophan have been reported, until more is known, people taking venlafaxine are cautioned to avoid 5-HTP or L-tryptophan.

Sodium

One case was reported of a 79-year-old woman with depression treated with venlafaxine who experienced hyponatremia (abnormally low blood levels of sodium).⁵ It remains unclear whether this interaction has any but rare ramifications.

Interactions with Herbs

Sour date nut (Ziziphus jujube)

There is one published report of a woman collapsing after taking venlafaxine in combination with the Chinese herbal remedy sour date nut (Ziziphus jujube),⁶ although she tolerated venlafaxine by itself without side effects. People taking venlafaxine should not take sour date nut.

St. John's wort(Hypericum perforatum)

Although there have been no interactions reported in the medical literature, it is best to avoid using venlafaxine with St. John's wort unless you are under the supervision of a qualified healthcare professional.

Other Interactions

Food

Venlafaxine is recommended to be taken with food.⁷

Alcohol

Venlafaxine may cause dizziness or drowsiness.⁸ Alcohol may intensify these effects and increase the risk of accidental injury.⁹ To prevent problems, people taking venlafaxine should avoid alcohol.

References

1. Brubacher JR, Hoffman RS, Lurin MJ. Serotonin syndrome from venlafaxine-tranylcypromine interaction. Vet Hum Toxicol 1996;38:358-61.
2. Weiner LA, Smythe M, Cisek J. Serotonin syndrome secondary to phenelzine-venlafaxine interaction. Pharmacotherapy 1998;18:399-403.
3. Bhatara VS, Magnus RD, Paul KL, Preskorn SH. Serotonin syndrome induced by venlafaxine and fluoxetine: a case study in polypharmacy and potential pharmacodynamic and pharmacokinetic mechanisms. Ann Pharmacother 1998;32:432-6.
4. Diamond S, Pepper BJ, Diamond ML, et al. Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports. Neurology 1998;51:274-6.
5. Ranieri P, Franzoni S, Rozzini R, Trabucchi M. Venlafaxine-induced reset osmostat syndrome: case of a 79-year-old depressed woman. J Geriatr Psychiatry Neurol 1997;10:75-8.
6. Stewart DE. Venlafaxine and sour date nut. Am J Psychiatry 2004;16:1129-30.
7. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Venlafaxine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1995, 263r-3x.
8. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Venlafaxine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1995, 263r-3x.
9. Threlkeld DS, ed. Central Nervous System Drugs, Antidepressants, Venlafaxine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1995, 263r-3x.

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Last Review: 09-01-2007

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