Does Effexor Make Bipolar Worse? (+3 Factors)

By Dr Drielli Vital-Fujii (PhD)

Page last updated: 02/01/2024 | Next review date: 02/01/2026

Author bio

Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.

Dr Drielli Vital-Fujii’s Highlights:

Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.

PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)

Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil

Professional Experience:

2012 – 2018 Project manager at University of São Paulo – Pharmacy Department

Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.

2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.

She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).

2018 – 2019 Faculdades Oswaldo Cruz

Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.

2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department

She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.

2023-2023 UniPiaget – University Center.

Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.

Education:

2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo

2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo

2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo

2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes

The leading publications of Dr Drielli Vital-Fujii are:

Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.

Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.

Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.

Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.

Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.

Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.

Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.

Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.

Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.

You can view some of Dr Drielli’s work below and links to her professional profile.

Orcid: https://orcid.org/0000-0001-9270-0466

Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii

Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000

Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR

Linkedin: linkedin.com/in/driellivital

Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital

CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists

Dr Drielli Vital-Fujii (PhD)

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In this article, we will discuss whether Effexor (Venlafaxine) can aggravate bipolar disorder. We will also discuss some research studies and how to manage if this side effect occurs.

Does Effexor make bipolar worse?

Effexor (Venlafaxine) can make bipolar worse. Effexor does not cause bipolar disorder. However, it can aggravate the symptoms of an already-existing bipolar disorder by triggering manic or hypomanic episodes.

Effexor is an antidepressant used to treat major depressive disorder and certain anxiety disorders (1). When it comes to individuals with bipolar disorder, the use of antidepressants like Effexor is associated with a risk of including a manic or hypomanic episode.

If someone with bipolar disorder is prescribed Effexor or any other antidepressant, close monitoring for changes in mood, signs of mania, and hypomania is crucial. It is essential to communicate any concerns or changes in mood to a healthcare provider promptly.

How can Effexor make bipolar worse?

Effexor, an SSRI, may pose challenges in individuals with bipolar disorder. Its mechanism involves increasing serotonin levels in the brain by inhibiting its reuptake by the brain cells, which in turn alleviates depressive symptoms.

However, Effexor carries the risk of triggering manic or hypomanic episodes in individuals with bipolar disorder when used without a mood stabilizer. Effexor focuses on depression, lacking mood-stabilizing properties. So, using Effexor alone without a mood stabilizer can shift people from depression to mania.

Therefore, consultation with a healthcare provider is crucial for managing bipolar disorder effectively.

What does research suggest?

There is limited study regarding the aggravation of bipolar disorder while using Effexor. However, Effexor being an antidepressant can help with bipolar disorder along with antipsychotics.

One study indicated that using Effexor (Venlafaxine) for a brief period of six weeks could be a safe and helpful way to treat serious sadness in people with bipolar II disorder (2).

Another study indicated that in bipolar disorder when a person feels very sad and down, doctors often prescribe antidepressants even though they might not work well and could sometimes make a person switch to feeling overly excited or energetic (3).

This study was conducted on 662 individuals and the results indicated that 69% i.e. 456 out of 662 individuals experienced manic episodes. However, when a mood stabilizer such as Lithium and antipsychotic medication such as Olanzapine was prescribed along with the antidepressant, the patients recovered well (3).

In some cases, individuals with bipolar disorder may initially be misdiagnosed with unipolar depression ( major depressive disorder) because the depressive episodes are more prominent and they seek treatment for depression.

If such individuals are prescribed an antidepressant, like Effexor, without a mood stabilizer, it can potentially lead to a manic or hypomanic episode. Therefore a healthcare professional must conduct a thorough evaluation of a person’s mental health history and symptoms before prescribing medications like Effexor.

What factors can worsen bipolar disorder while taking Effexor?

Several factors can potentially worsen bipolar disorder while taking Effexor. These include:

Manic or hypomanic episodes: Effexor, being an antidepressant can trigger a switch from depression to a manic or hypomanic state in some individuals with bipolar disorder.

Rapid cycling: Effexor might contribute to an increase in the frequency of mood swings, leading to rapid cycling between depressive and manic episodes in some people with bipolar disorder.

Dosage and treatment duration: Higher doses of Effexor or prolonged use may increase the risk of mood swings and worsening symptoms of bipolar disorder.

Medication interactions: Interactions with other medications can sometimes exacerbate bipolar symptoms. It is crucial to discuss all medications, including over-the-counter supplements and prescriptions, with a healthcare professional.

Absence of mood stabilizer: Effexor, when used alone without a mood stabilizer or antipsychotic, can potentially worsen bipolar. Combining it with a mood stabilizer is often recommended to reduce the risk of mood swings.

Individual sensitivity: Every person responds differently to medications. Effexor may not suit everyone with bipolar disorder, and its effects can vary widely among individuals.

What to do if Effexor worsens your bipolar?

If Effexor worsens your bipolar reach out to your healthcare provider. They will conduct a thorough evaluation to determine whether Effexor is the main culprit.

They may initially reduce the dose of Effexor to see if it works. If dose reduction does not work, they may gradually taper off your medication or switch to another treatment plan, such as (4):

Mood stabilizers

Lamotrigine
Valproate
Lithium

Antipsychotic medications

Aripiprazole
Olanzapine
Quetiapine

Do not discontinue or withdraw Effexor without consulting your healthcare provider as it may cause withdrawal symptoms such as hallucinations, agitation, tremors, mood disorders etc (5).

Conclusion

In my opinion, Effexor can potentially worsen bipolar disorder by triggering mania or hypomania. It is essential to use caution when prescribing Effexor to individuals with bipolar disorder, as it may lead to mood destabilization if not combined with a mood stabilizer. Closed monitoring and individualized treatment plans are crucial to mitigate the risk of worsening bipolar symptoms while using Effexor.