(deaths per million prescriptions) found that venlafaxines fatal toxicity is higher than that of other serotoninergic antidepressants but it is similar to that of some of the less toxic tricyclic antidepressants. Overall they found serious toxicity could occur following venlafaxine overdose with reports of deaths, arrythmias, and seizures. They did, sin embargo, state that this type of data is open to criticism pointing out that mortality data may be influenced by previous literature and that "less toxic" drugs may be preferentially prescribed to patients at higher risk of poisoning and suicide but they are also less likely to be listed as the sole cause of death from overdose. It also assumes that drugs are taken in overdose with similar frequency and in similar amounts. They suggested "clinicians need to consider whether factors in their patients reduce or compensate for this risk before prescribing venlafaxine."[26] The February 27, 2007 Vancouver Sun reported that the BC Drug and Poison Information Centre has alerted doctors that the drug poses a significant risk of death from overdose, saying that venlafaxine "appears more toxic than it was originally hoped".[27] A doctor from the Department of Pharmacy Services College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, reported on the death of a 39-year-old patient with a 30 g overdose.[22] Management of Overdosage There is no specific antidote for venlafaxine and management is generally supportive, providing treatment for the immediate symptoms. Administration of activated charcoal can prevent absorption of the drug. Monitoring of cardiac rhythm and vital signs is indicated. Seizures are managed with benzodiazepines or other anti-convulsants. Forced diuresis, hemodialysis, exchange transfusion, or hemoperfusion are unlikely to be of benefit in hastening the removal of venlafaxine, due to the drug's high volume of distribution.[28] Footnotes ↑ Jump up to: 1.0 1.1 Whyte I, Dawson A, Buckley N (2003). Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants. QJM 96 (5): 369-74. PMID 12702786. ↑ [No Authors listed]. Acute Effectiveness of Additional Drugs to the Standard Treatment of Depression. ↑ Goeringer K, McIntyre I, Drummer O (2001). Postmortem tissue concentrations of venlafaxine. Forensic Sci Int 121 (1-2): 70-5. PMID 11516890. ↑ Wellington K, Perry C (2001). Venlafaxine extended-release: a review of its use in the management of major depression.. Fármacos del SNC 15 (8): 643-69. PMID 11524036. ↑ Saltar hasta: 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 (2006). Effexor Medicines Data Sheet. Wyeth Pharmaceuticals Inc. ↑ Saltar hasta: 6.0 6.1 Parker G, Blennerhassett J (1998). Withdrawal reactions associated with venlafaxine. Aust N Z J Psychiatry 32 (2): 291-4. PMID 9588310. ↑ Rowbotham M, Goli V, Kunz N, Lei D (2004). Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study. Dolor 110 (3): 697-706. PMID 15288411. ↑ Ozyalcin S, Talu G, Kiziltan E, Yucel B, Ertas M, Disci R (2005). The efficacy and safety of venlafaxine in the prophylaxis of migraine. Headache 45 (2): 144-52. PMID 15705120. ↑ Mayo Clinic staff (2005). Beyond hormone therapy: Other medicines may help. Hot flashes: Ease the discomfort of menopause. Clínica Mayo. ↑ Schober C, Ansani N (2003). Venlafaxine hydrochloride for the treatment of hot flashes. Ann Pharmacother 37 (11): 1703-7. PMID 14565812. ↑ Courtney D (2004). Selective serotonin reuptake inhibitor and venlafaxine use in children and adolescents with major depressive disorder: a systematic review of published randomized controlled trials. Can J Psiquiatría 49 (8): 557-63. PMID 15453105. ↑ Gentile S (2005). The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf 28 (2): 137-52. PMID 15691224. ↑ de Moor R, Mourad L, ter Haar J, Egberts A (2003). [Withdrawal symptoms in a neonate following exposure to venlafaxine during pregnancy]. Ned Tijdschr Geneeskd 147 (28): 1370-2. PMID 12892015. ↑ DeVane CL. (2003). Immediate-release versus controlled-release formulations: pharmacokinetics of newer antidepressants in relation to nausea. J Clin Psiquiatría 64 (Suppl 18): 14-9. PMID 14700450. ↑ Wigginton, Catherine (2006-09-19), Wyeth's Battle for Effexor Continues, IP Law & Business, HTTP://, recuperado el 2007-04-25 ↑ Mines D, Hill D, Yu H, Novelli L (2005). Prevalence of risk factors for suicide in patients prescribed venlafaxine, fluoxetine, and citalopram. Farmacoepidemiología de seguridad de medicamentos 14 (6): 367-72. PMID 15883980. ↑ Adan-Manes J, Novalbos J, López-Rodríguez R, Ayuso-Mateos J, Abad-Santos F (2006). Lithium and venlafaxine interaction: a case of serotonin syndrome. J Clin Pharm Ther 31 (4): 397-400. PMID 16882112. ↑ Saltar hasta: 18.0 18.1 18.2 Haddad P (2001). Antidepressant discontinuation syndromes. Drug Saf 24 (3): 183-97. PMID 11347722. ↑ Fava M, Mulroy R, Alpert J, Nierenberg A, Rosenbaum J (1997). Emergence of adverse events following discontinuation of treatment with extended-release venlafaxine. Am J Psiquiatría 154 (12): 1760-2. PMID 9396960. ↑ Double D (1997). Prescribing antidepressants in general practice. People may become psychologically dependent on antidepressants. BMJ 314 (7083): 829. PMID 9081020. ↑ Blythe D, Hackett L (1999). Cardiovascular and neurological toxicity of venlafaxine. Hum Exp Toxicol 18 (5): 309-13. PMID 10372752. ↑ Saltar hasta: 22.0 22.1 Mazur J, Doty J, Krygiel A (2003). Fatality related to a 30-g venlafaxine overdose. Pharmacotherapy 23 (12): 1668-72. PMID 14695048. ↑ Banham N (1998). Fatal venlafaxine overdose. Med J Aust 169 (8): 445, 448. PMID 9830400. ↑ MHRA UK (Mayo 31 2006). Updated product information for venlafaxine. Safeguarding public health. ↑ (2006). Wyeth Letter to Health Care Providers. Wyeth Pharmaceuticals Inc. ↑ Buckley N, McManus P (2002). Fatal toxicity of serotoninergic and other antidepressant drugs: analysis of United Kingdom mortality data. BMJ 325 (7376): 1332-3. ↑ Fayerman, Pamela Warning issued over drug. Vancouver Sun. URL a la que se accede en 2007-06-02. ↑ Hanekamp B, Zijlstra J, Tulleken J, Ligtenberg J, van der Werf T, Hofstra L (2005). Serotonin syndrome and rhabdomyolysis in venlafaxine poisoning: a case report.. Neth J Med 63 (8): 316-8. PMID 16186642. External links Drug information U.S. Food and Drug Administration information on Effexor Efexor patient information leaflet Efexor patient information leaflet Effexor XR® prescribing information for healthcare professionals (pdf) (USA only) Detailed Patient/Parent Information on Effexor exellent Industry pages The Offical website of Effexor XR The Official website of Effexor XR Patient experiences Effexor petition by users detailing severe discontinuation effects and concerns Effexor Side Effects Patient comments. Stutz, Bruce "Self-Nonmedication" New York Times Magazine May 6, 2007 Chemical data Link page to external chemical sources. 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