Does Effexor cause brain damage? (+1 effects)

In this article, we will discuss if Effexor can cause brain damage. Effexor (venlafaxine) is prescribed for depression and anxiety disorders including generalized anxiety disorder, panic disorder, and major depressive disorder.

Does Effexor cause brain damage?

Effexor may or may not cause brain damage. Preclinical studies demonstrate that Effexor’s antidepressant effect is frequently coupled with an increase in serotonergic neurotransmission at low doses.

High doses of Effexor, which cause an increase in serotonin and norepinephrine tone, are linked to alterations in different types of plasticity in specific brain regions. The hippocampus, in particular, appears to play an important role in Effexor-mediated antidepressant effect.

Such an effect occurs most notably via modulating processes such as adult hippocampal neurogenesis and excitatory/ inhibitory balance. Thus, there are very rare chances that Effexor would lead to brain damage in adults. 

How does Effexor prevent brain damage?

The brain contains numerous antioxidant systems that counteract the damaging effects of ROS (reactive oxygen species) and RNS (reactive nitrogen species). However, in depression, the inefficiency of the antioxidant mechanism and changes in the proinflammatory cytokine system result in increased free radical generation due to phagocytic cell activation. 

Effexor is a prescription antidepressant that works by inhibiting both serotonin and norepinephrine transporters. It prefers serotonin reuptake over norepinephrine uptake. Effexor has also been reported to control depression-induced oxidative stress in the brain and medulla of rats.

Effexor’s effect on nitric acid (NO) and RNS generation was also suggested in its antidepressant effect. ROS and RNS can cause neuronal injury in the brain by depleting non-enzymatic antioxidants (1, 2).

What does research on animals suggest?

In animal studies, Effexor has been reported to reverse the brain damage induced by depression. In one of the studies, Effexor reduced lipid peroxidation levels and nitric oxide levels in the cortex brain.

Effexor also increased the Vitamin C concentration and glutathione peroxidase activity in the cortex. Thus the authors concluded that Effexor prevents oxidative stress, thereby reducing depression in animal models (1).

In another study, long-term Effexor treatment protected the mice against oxidative cellular and DNA damage in the hippocampus caused by stress. This activity could be accomplished by combating oxidative stress and strengthening antioxidant defence mechanisms (2). 

A conflicting study demonstrated that Effexor caused oxidative stress and DNA damage in mouse brains at therapeutic and nontherapeutic (excess) doses. The DNA damage began 2 hours post-administration and continued for 12 hours (3).

What does the human clinical data suggest?

In a rare case report, a woman taking antituberculosis therapy experienced Effexor-induced seizure when the dose of Effexor was increased from 37.5 mg to 75 mg. The patient exhibited no further seizures when the dose of Effexor was reduced. However, the authors did not establish the possible effect of the antituberculosis drug in the induction of seizures (4). 

What are the cautions while taking Effexor?

Effexor should be used with caution if the patient has any of the following medical history (4, 5):

  • Brain disease: Effexor should be used with caution in patients who have previously experienced brain damage, or has a history of seizures.
  • Mania: the risk of developing mania can increase while taking Effexor.
  • Heart disease or blood pressure: Effexor may worsen the condition. It can increase or lower the blood pressure as a side effect.
  • Kidney or liver disease: dose adjustment is necessary if the patient has impaired liver or kidney.

Can Effexor use during pregnancy cause brain damage to the baby?

When taken during pregnancy, Effexor has been linked to birth defects and abnormalities. Effexor has been classified as Pregnancy category C by the FDA. It can induce the following defects in the brains of newborn babies:

  • Craniosynostosis: a condition that causes improper skull and brain growth.
  • Anencephaly: absence of the part of the brain or skull.

Other birth defects might include:

  • Respiratory distress,
  • cleft lip and palate,
  • premature delivery, and
  • heart abnormalities and defects.

What are the warning signs for brain damage while taking Effexor?

The severity of brain damage depends on the seriousness of the side effects induced by Effexor. A minor brain damage could be only temporary and go away with time. It causes a headache, dizziness, memory loss, insomnia and nausea. 

Symptoms of moderate brain damage can be severe and stay for a longer time. In both circumstances, the majority of patients recover well. Severe brain damage can result in life-changing and disabling issues.

The patients will be cognitively, perpetually, physically, and behaviorally challenged. People in a coma or a minimally responsive state may be dependent on others to care for the rest of their lives.

  • Cognitive symptoms: these will include difficulty in processing thoughts, and information, and impaired decision-making ability.
  • Perceptual symptoms: these will include spatial disorientation, change in vision, hearing and sense of touch, balance issues, and increased pain sensations.
  • Physical symptoms: these will include seizures, paralysis, tremors, sleep disorders, fatigue and headache.
  • Behavioural symptoms: these will include sluggishness, irritability, increased aggressiveness, and reduced tolerance to depression.

What should be done in the case of brain damage?

The doctor will reduce the dose of Effexor gradually and discontinue the drug. The mild symptoms will go away on their own. However, in case of serious issues related to brain damage, the patient would need the following:

  • Physical therapy,
  • Speech therapy,
  • occupational therapy, and 
  • psychological support.

Based on the literature survey, there are very few cases reported of Effexor-induced brain damage. So I would suggest you to take this medication for your depression as prescribed by the doctor. I always keep a strong followup with my doctor and report any abnormalities and side effects on priority basis.

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References

1.-

Eren I, Nazıroğlu M, Demirdaş A, Çelik Ö, Uğuz AC, Altunbaşak A, Özmen İ, Uz E. Venlafaxine modulates depression-induced oxidative stress in brain and medulla of rat. Neurochemical Research. 2007 Mar;32:497-505. https://link.springer.com/article/10.1007/s11064-006-9258-9

2.-

Abdel-Wahab BA, Salama RH. Venlafaxine protects against stress-induced oxidative DNA damage in hippocampus during antidepressant testing in mice. Pharmacology Biochemistry and Behavior. 2011 Nov 1;100(1):59-65. https://d1wqtxts1xzle7.cloudfront.net/68508878/0a85e53b3504ba07ba000000.pdf

3.-

Madrigal-Bujaidar E, Paniagua-Pérez R, Rendón-Barrón MJ, Morales-González JA, Madrigal-Santillán EO, Álvarez-González I. Investigation of the DNA Damage and Oxidative Effect Induced by Venlafaxine in Mouse Brain and Liver Cells. Toxics. 2022 Nov 29;10(12):737. https://www.mdpi.com/2305-6304/10/12/737

4.-

Ye C, Ninneman M, Christian JS, Zhang F, Musselman D. Seizure induced by a therapeutic dose of venlafaxine ER: a case report. Journal of Psychiatric Practice®. 2018 Mar 1;24(2):117-20. https://journals.lww.com/practicalpsychiatry/abstract/2018/03000/seizure_induced_by_a_therapeutic_dose_of.8.aspx

5.-

Patel R, Reiss P, Shetty H, Broadbent M, Stewart R, McGuire P, Taylor M. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ open. 2015 Dec 1;5(12):e008341. https://bmjopen.bmj.com/content/5/12/e008341

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