Information For Patients About EFEXOR/PRISTIQ

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Information For Patients About EFEXOR/PRISTIQ

AIM: This medication is intended to correct the chemical changes in your body, which are associated with depressive illness.  This normally takes 3 to 4 weeks,  but may take 6 weeks.   This medication is a class of antidepressant, known as the Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs).    This medication is designed to simultaneously improve transmission of chemical messages in the brain using the two chemical pathways current research suggests are most relevant in depressive illness, being the Serotonin pathway and the Noradrenaline pathway.

We know that the vast majority of individuals with depressive illness will benefit from one of the available antidepressant agents,  but we do not know how antidepressants achieve this effect, similar to the initial years when antibiotics were first used.  At present it is not possible to predict which particular medication is best suited to any individual patient’s chemistry, so that the antidepressant first prescribed may need to be changed after some time if it is not effective.  Statistically, any antidepressant has a 70% change of helping an individual patient.

DOSAGE: Unlike some other antidepressants, there is a direct relationship between increasing doses of Efexor and increasing benefits from this medication,  but unfortunately also increasing side effects.  Accordingly, you will be advised to start with a low dose of the medication and increase the dose only if necessary.  Most people respond to 150 mg a day of the medication and the maximum recommended dose is 375 mg per day.

TIMING:  Normally the tablets are to be taken in the morning.

SIDE EFFECTS: You may experience some or none of the following :

  1. Nausea – taking the medication after food may be very useful.  
  2. Dizziness or unsteadiness
  3. Excessive tiredness – if this occurs, try taking the medication at night only.  However in some patients, the medication can actually interfere with their sleep.
  4. Constipation – taking mild laxatives may overcome this problem.
  5. Sexual difficulties – these are usually related to the dose of the medication you are taking.
  6. Excessive perspiration – a simple antidote medication (Probanthine or Catapres) may be effective for this side effect.
  7. Dry mouth – if you develop this, good dental hygiene is important as you are at risk of teeth and gum damage, due to the absence of saliva.  Bitter drinks, sugarless gum or an antidote medication (Urocarb) may help if needed.
  8. Weight gain.

NEED TO VARY DOSAGE: This medication will eventually overwhelm your symptoms, if it works for you.  With no symptoms left to absorb the powerful medication, you may experience yawning, drowsiness, difficulty finding the right word, or simple errors in spelling or calculation.  Reduce the medication for 2 or 3 days, until these problems resolve and restart at a lower dose.  At times of extra stress, you may need to increase the dose (so that your concentration and memory are back to normal, being good indicators or good symptom control).  

LENGTH OF TREATMENT: Once you recover, you will need to keep taking the tablets for some months afterwards, to prevent the chemical imbalance from returning.  These tablets are not at all addictive.  It is important to reduce the dose gradually to prevent withdrawal sensations in your body (which feel like you are suffering from ‘flu, or “zaps” in your head or dizziness). Unfortunately, some people become resistant to this medication and need to change it as the benefits fade.

PRECAUTIONS : Do not take these tablets :

  1. If you develop a rash or hives while taking this medication.
  2. If you have taken Parnate within the previous 2 weeks.
  3. If you intend becoming pregnant in the next month.

 

USE OF ALCOHOL: You can have a small amount of alcohol quite safely with these tablets,  but do remember that one drink may have the effect of 2 or 3 drinks.

COUGHS & COLDS:  The warning not to take Sudafed, Sinutabs etc if taking antidepressants does not apply to this medication.

This information is intended to improve your knowledge of the treatment you are receiving.  Any further points can be discussed at your next consultation with me.

MAY BE REPRODUCED FOR GENERAL PATIENT USE,  BUT PLEASE ACKNOWLEDGE SOURCE

DR DAVID HORGAN ACCEPTS RESPONSIBILITY ONLY FOR HIS OWN PATIENTS IN THE USE OF THIS MATERIAL