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Venlafaxine: unjustifiable cardiovascular risks

There is considerable evidence that venlafaxine carries an increased risk of adverse cardiovascular effects and of overdose deaths, compared with most other "selective" serotonin reuptake inhibitors (SSRIs), whereas the efficacy of all SSRIs is similar – and limited.

The antidepressants that are on the market appear to be similar in terms of efficacy, but differ with regard to their adverse effects, depending on their mechanism of action.

Venlafaxine shares the adverse effects of "selective" serotonin reuptake inhibitors (SSRIs), but is associated with additional adverse effects, especially cardiovascular – tachycardia, hypertension, severe cardiac arrhythmia – which are foreseeable, given its pharmacological profile.

These adverse effects appear to be more frequent than with most SSRIs. They are generally fatal in the case of overdose, with no compensation in terms of efficacy.

Amongst the SSRI antidepressants, citalopram and its derivative escitalopram ought to be ruled out as well since they too expose patients to an increase in adverse cardiovascular effects, whereas they offer no benefit in terms of efficacy.

©Prescrire 1 April 2016

"Venlafaxine: more dangerous than most "selective" serotonergic antidepressants" Prescrire Int 2016; 25 (170): 96-99. (Pdf, subscribers only).
Download the full review.
Pdf, subscribers only

See also:

SSRI antidepressants:
extrapyramidal reactions
Prescrire Int 2016;
25 (170): 100.
Pdf, free

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