What type of drug is venlafaxine?

From the Guidelines

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI).

Key Characteristics of SNRIs

• SNRIs inhibit the presynaptic reuptake of both norepinephrine and serotonin in the brain, modulating stress responses such as alertness, arousal, attentiveness, and vigilance 1
• Medications from the SNRI class currently marketed in the United States include venlafaxine, desvenlafaxine, duloxetine, and levomilnacipran 1
• The primary mechanism of action of SNRIs is deemed sufficiently similar across individual medications to warrant extension of the findings to the medication class, despite varying effects on other neurotransmitter receptors 1

Clinical Use of Venlafaxine

• Venlafaxine is used in the treatment of anxiety disorders, including generalized anxiety disorder in children and adolescents 1
• The choice of medication for anxiety within the SNRI class may be governed by considerations such as pharmacokinetics, pharmacodynamics, tolerability, cost, and insurance formularies 1
• Venlafaxine has been shown to be effective in the treatment of depression, with some studies suggesting a therapeutic advantage for SNRIs over SSRIs, although the evidence is not conclusive 1

Important Considerations

• Venlafaxine extended release has a sufficiently long elimination half-life to permit single daily dosing, while the immediate release form may require twice- or thrice-daily dosing due to its short elimination half-life 1
• The efficacy and safety of venlafaxine have been evaluated in various studies, including head-to-head comparisons with other antidepressants, although the results are not always consistent 1

From the FDA Drug Label

Venlafaxine hydrochloride (HCl), USP is a structurally novel antidepressant for oral administration.

Venlafaxine is an antidepressant, specifically a serotonin-norepinephrine reuptake inhibitor (SNRI) as mentioned in the clinical pharmacology section of the label 2.

• Key characteristics:
  • Potent inhibitor of neuronal serotonin and norepinephrine reuptake
  • Weak inhibitor of dopamine reuptake
  • No significant affinity for muscarinic, histaminergic, or α-1 adrenergic receptors
  • No monoamine oxidase (MAO) inhibitory activity 2

From the Research

Classification of Venlafaxine

• Venlafaxine is classified as a serotonin norepinephrine reuptake inhibitor (SNRI) 3, 4, 5, 6, 7

Mechanism of Action

• Venlafaxine works by blocking the reuptake of both serotonin (5-HT) and norepinephrine (NE) 5, 6
• At low therapeutic doses, venlafaxine selectively inhibits 5-HT uptake, and at higher therapeutic doses, it inhibits both 5-HT and NE uptake 6

Pharmacological Properties

• Venlafaxine has a relatively benign side-effect profile compared to older antidepressants 5
• It may exert a rapid onset of action and appears to be particularly effective in moderate-to-severe depression and in patients who have treatment-refractory depression 5