Alcohol use disorders, including both abuse and dependence, are believed to affect up to 30 percent of adult Americans. Alcoholism is often accompanied by mood disorders, both as a cause and effect of alcohol abuse. About 40 to 50 percent of individuals with bipolar disorder develop alcohol use disorders sometime during their lives, and people who suffer from depression often use alcohol to self-medicate. Conversely, people who abuse alcohol often develop mood disturbances as a result of their alcoholism. Extended-release venlafaxine – Effexor ER – could prove useful for alcoholics with mood disorders, but its use should be approached with caution in this population.
Mechanism
Mood disorders, such as depression and bipolar disorder, are assumed to stem from disruptions in neurotransmitter levels in your brain. Alcohol abuse contributes to neurotransmitter deficits and, in the long run, worsens your mood. Medications designed to treat these “chemical imbalances” exert their effects by restoring neurotransmitter levels to a more normal state. Effexor is classified as a serotonin-norepinephrine reuptake inhibitor, or SNRI. It increases the levels of two neurotransmitters – serotonin and norepinephrine – by preventing your brain cells from reabsorbing and deactivating these chemicals. Effexor is used to treat depression, anxiety and panic disorders.
Benefits for Alcoholics
A study published in the 2007 issue of the Spanish journal “Addiciones” demonstrated that Effexor ER was useful for reducing cravings among 55 hospitalized alcoholic patients. In addition, Effexor ER significantly reduced these patients’ psychiatric symptoms and improved their family and social relations. Daily dosages of Effexor ER varied from 75 to 225 mg during this six-month study. Another Spanish study, conducted in 2005 at the University of Oviedo and involving 90 outpatients with both alcohol dependence and major depression, showed that Effexor was effective for treating depression in alcoholics. This study also lasted six months, but improvements in patients’ moods were noted as early as two weeks after initiating drug therapy.
Suicide Risk
Both bipolar disorder and major depression are associated with an increased risk for suicide, and alcohol use heightens this risk even further. For example, a July 2010 review in “The Journal of Clinical Psychiatry” showed that bipolar patients who abuse alcohol are more than twice as likely to commit suicide as their non-alcoholic counterparts. Interestingly, abuse of other drugs did not increase the baseline risk for suicide among patients with bipolar disorder. Therefore, management of mood disorders in alcoholic patients is essential for reducing their suicide risk.
Considerations
Effexor ER may be a useful medication for improving mood in an alcoholic, but it may not be the best choice in all cases. Venlafaxine can cause a mild elevation of your blood pressure, and high blood pressure is often already a problem in alcoholism. In addition, according to a May 2011 review in “International Journal of Legal Medicine,” compared to other commonly used antidepressants, venlafaxine is more frequently implicated in suicides due to drug overdoses, and venlafaxine’s tendency to interact with other medications increases the risk for completed suicide. Thus, an alcoholic with a mood disturbance should only use Effexor ER under close medical supervision.
References
- “The Journal of Clinical Psychiatry”; Increased Risk for Suicidal Behavior in Comorbid Bipolar Disorder and Alcohol Use Disorders; M. A. Oquendo, et al.; July 2010
- Drugs.com: Effexor
- “Addiciones”; Venlafaxine Extended Release and Alcohol Dependence; David Cáceres, et al.; 2007
- “Actas Españolas de Psiquitría”; Effectiveness of Venlafaxine in the Treatment of Alcohol Dependence With Comorbid Depression; M. P. García-Portilla, et al.; Jan-Feb 2005
- “International Journal of Legal Medicine”; Fatal Venlafaxine Poisonings Are Associated With a High Prevalence of Drug Interactions; T. Launiainen, et al.; May 2011
