Effexor is the trade name for the drug venlafaxine, the first member of the drug group called serotonin and norepinephrine reuptake inhibitors (SNRIs). These drugs prolong the activity of the neurotransmitters serotonin and norepinephrine in the brain. The SNRIs were developed as antidepressants, but are also used to treat other conditions. Effexor is approved by the U.S. Food and Drug Administration (FDA) for the treatment of major depressive disorder, generalized anxiety disorder, social anxiety disorder and panic disorder. Other medications in the SNRI group that are similar to Effexor include duloxetine, desvenlafaxine and milnacipran.
Duloxetine
Duloxetine is an SNRI approved by the FDA for the treatment of major depressive disorder, generalized anxiety disorder, fibromyalgia and diabetes-related peripheral neuropathy pain. Duloxetine received FDA approval in 2008. All SNRIs carry a black box warning--the FDA's most stringent warning--regarding a risk for suicidal thoughts and behaviors associated with these medications. Adolescents and young adults have the greatest risk for this serious side effect. Duloxetine is not FDA-approved for use in children.
The use of duloxetine for diabetes-related peripheral neuropathy pain may seem unusual, but is not without precedent. Anti-seizure medicines--which, like duloxetine, work by affecting neurotransmitters in the brain--are a mainstay of treatment for diabetes-related peripheral neuropathy pain. Hence, it is logical to consider duloxetine might also be useful for this condition. In a 2009 study published in the journal "BioMed Central Neurology," lead author Sibilia Quilici and her colleagues reported duloxetine was as effective as the antiseizure medicines gabapentin and pregabalin for the treatment of diabetes-related peripheral neuropathy pain.
Desvenlafaxine
Desvenlafaxine is an SNRI approved by the FDA in 2008 for the treatment of major depressive disorder. The National Institute of Mental Health estimates 14.8 million American adults have major depression. Desvenlafaxine carries the same black box warning related to an increased risk of suicidal thoughts and behaviors that other SNRIs do. Desvenlafaxine is not FDA approved for use in children. Off-label uses--those not approved by the FDA--of desvenlafaxine include treatment of hot flashes and premenstrual dysphoric disorder.
Milnacipran
Milnacipran is an SNRI approved by the FDA in 2009 for the treatment of fibromyalgia. It carries the FDA-mandated SNRI warning regarding increased suicide risk. Milnacipran is not FDA approved for use in children. Off-label uses of milnacipran include treatment of depression, bulimia nervosa and anxiety associated with major psychiatric disorders.
