Social anxiety disorder venlafaxine

Social anxiety disorder Escitalopram Fluvoxamine Paroxetine Sertraline Venlafaxine XR Citalopram Clonazepam Buspirone Gabapentin Miitazapine Phenelzine Pregabalin... 

Serotonin-Boosting Antidepressants. The SSRIs have also been studied in the treatment of generalized social anxiety disorder, and paroxetine, sertraline, and venlafaxine are effective. Preliminary data suggests that the serotonin-boosting atypical antidepressants (mirtazapine and nefazodone) may also be helpful. Like the MAOIs, they appear to be effective at doses comparable to those used to treat depression. They may help avoidant patients to gradually increase their social interaction and become more assertive. 

SSRI/SNRI GAD OCD Panic disorder PTSD Social anxiety disorder Onset worsening side-effects on initiation few long-term effects Relatively safe in overdose (venlafaxine possibly less safe) Well-described more common with paroxetine uncommon with fiuoxetine... 

Social anxiety disorder is an uncommonly diagnosed but a fairly common condition in which the patient experiences severe anxiety in social interactions. This anxiety may limit their ability to function adequately in their jobs or interpersonal relationships. Several SSRIs and venlafaxine are approved for the treatment of social anxiety. The efficacy of the SSRIs in the treatment of social anxiety is greater in some studies than their efficacy in the treatment of MDD. 

The selective serotonin reuptake inhibitors or venlafaxine are considered first-line pharmacotherapy for social anxiety disorder, especially in patients with comorbid depression, other anxiety disorders, or substance abuse. 

Stein MB. Long-term treatment of generalized social anxiety disorder with venlafaxine XR [poster]. 23rd Annual Congress of the Anxiety Disorder Association of America, Toronto, May 2003. 

Davidson JRT, Manguano RM. Venlafaxine XR in social anxiety disorder [poster]. Xll World Congress of Psychiatry, Yokohama, Japan, August 2002. 

Venlafaxine is a serotonin and norepinephrine reuptake inhibitor that potentiates norepinephrine, serotonin, and dopamine neurotransmitter activity in the CNS by inhibiting their neuronal reuptake. Effexor, Effexor XR are used in treatment of major depressive disorder. Effexor XR is used in treatment of generalized anxiety disorder and treatment of social anxiety disorder. 

Venlafaxine 37.5 mg bd or 75 mg MR >2 weeks, 75 mg increments 375 mg For depression GAD, social anxiety disorder Caution in CVD Monitor BP if CVD or higher doses GAD/social phobia, start at 75mg, max 225mg Don t delay doses ifnon-MR (discontinuation symptoms)... 

Another example of a dual SSRI/NARI is venlafaxine (Fig. 18.27), which one can view as a N,N-dimethylated and para-methoxy-phenylethylamine derivative, substituted with cyclohexanol at the (3-position. It only weakly inhibits dopamine transport and is commonly prescribed for depression but also for general and social anxiety disorder. 

Venlafaxine hydrochloride modified-release capsules (75 and 150 mg). Adult dose 75 mg as single dose (depression, general and social anxiety disorder). 

Indeed, 5-HT is also a substrate for the 5-HT transporter, itself an important player in the treatment of depression, and more recently for the whole range of anxiety disorders spectrum (GAD, OCD, social and other phobias, panic and post-traumatic stress disorders). It is the target for SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine, paroxetine, fluvoxamine, and citalopram or the more recent dual reuptake inhibitors (for 5-HT and noradrenaline, also known as SNRIs) such as venlafaxine. Currently, there are efforts to develop triple uptake inhibitors (5-HT, NE, and DA). Further combinations are possible, e.g. SB-649915, a combined 5-HTia, 5-HT1b, 5-HT1d inhibitor/selective serotonin reuptake inhibitor (SSRI), is investigated for the treatment of major depressive disorder. 

Antidepressant drugs, however, might have direct anxiolytic effects. That is, certain antidepressants such as paroxetine (Paxil) or venlafaxine (Effexor) can help reduce anxiety independent of their effects on depression.1,47 These antidepressants have therefore been advocated as an alternative treatment for anxiety, especially for people who cannot tolerate the side effects of traditional anxiolytics, or who might be especially susceptible to the addictive properties of drugs like the benzodiazepines.1,9,46 Moreover, antidepressants such as paroxetine or venlafaxine are now considered effective as the primary treatment for several forms of anxiety, including generalized anxiety disorder, social phobia, and panic disorder.4,29,53 Antidepressants, either used alone or in combination with antianxiety drugs, have become an important component in the treatment of anxiety. 

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