Does Venlafaxine Cause Heartburn? (+Risk Factors)

This article explores the relationship between venlafaxine and heartburn, discussing whether venlafaxine causes heartburn and examining the research conducted on the topic. It also delves into factors that may influence venlafaxine-induced heartburn.

Furthermore, it provides management strategies and tips to avoid or treat heartburn while taking venlafaxine.

Does venlafaxine cause heartburn?

It is very rare for venlafaxine to cause heartburn. While heartburn is one of the most common side effects in the majority of antidepressants, like tricyclic antidepressants, it is not commonly associated with venlafaxine.

Venlafaxine is not known to cause heartburn, but it is possible to suffer from heartburn while taking fluoxetine in the presence of other factors like underlying diseases and concomitant medications.

Moreover, venlafaxine can be used in managing heartburn in depressed patients. Some case studies found it to be effective in managing symptoms.

How can antidepressants like venlafaxine cause heartburn?

Venlafaxine is a serotonin-noradrenaline reuptake inhibitor (SNRI). While it primarily increases serotonin in the brain, it can also affect serotonin levels in the digestive system. Within the GI tract, serotonin plays a crucial role in regulating the movement of muscles, including the lower esophageal sphincter (LES) [1].

The LES is responsible for preventing stomach acid from refluxing back into the esophagus. Increased serotonin levels can potentially lead to the weakening of the LES. This can cause stomach acid to flow back into the esophagus, resulting in heartburn or gastroesophageal reflux disease (GERD) [1].

What does research suggest?

One investigation explored the use of Venlafaxine in treating non-erosive gastroesophageal reflux disease accompanied by depression and anxiety. The control group was treated with Esomeprazole and Mosapride, while the treatment group was given Esomeprazole, Mosapride, and venlafaxine [2].

The study found that adding Venlafaxine to medications significantly improved heartburn symptoms, with the treatment group having a higher total effective rate (96.1%) compared to the control group (79.1%).

This indicates that venlafaxine is effective in treating non-erosive gastroesophageal reflux disease accompanied by depression and anxiety [2]

In a case report, a patient taking citalopram and escitalopram presented with GERD, heartburn, and nausea. These symptoms were persistent despite adjustments in dosing [3].

Treatment with desvenlafaxine, which is the active form of venlafaxine, along with omeprazole for GERD resulted in successful management of symptoms. This suggests that venlafaxine can be considered one of the preferred antidepressants for patients with heartburn [3]. 

On the other hand, another study aimed to assess the effectiveness of venlafaxine in patients with functional dyspepsia, which is one of the conditions that cause heartburn. However, the study concluded that treatment with venlafaxine was not more effective than placebo [4].

To illustrate, 37% of the patients who took venlafaxine were symptom-free after 8 weeks, compared to 39% of those who took a placebo. Similarly, 42% of the venlafaxine group and 41% of the placebo group were symptom-free at 20 weeks [4].

This suggests that venlafaxine does not have a significant impact on functional dyspepsia, proving that it is very rare for it to cause heartburn [4].

What factors influence venlafaxine-induced heartburn?

While it is uncommon to experience heartburn while taking venlafaxine, several factors can contribute to this side effect. It is important to note that these factors may vary from person to person. Here are some possible causes and risk factors for venlafaxine-induced heartburn:

Underlying health conditions

Individuals with pre-existing gastrointestinal conditions such as gastroesophageal reflux disease (GERD), stomach ulcers, esophageal cancer, certain infections, or hiatal hernia may be more prone to experiencing heartburn while taking venlafaxine [5].

Most of these conditions can weaken the lower esophageal sphincter (LES), which normally prevents stomach acid from flowing back into the esophagus.

Moreover, stress and anxiety have been known to exacerbate gastrointestinal symptoms, including heartburn. Venlafaxine is commonly prescribed for anxiety disorders, so individuals who are already prone to stress or anxiety may be more susceptible to experiencing heartburn while taking this medication [4].

Lifestyles factors

Certain eating habits can increase the likelihood of experiencing heartburn. Consuming large meals or lying down immediately after eating can put pressure on the LES, leading to acid reflux and heartburn. Additionally, consuming spicy, fatty, or acidic foods may also trigger heartburn symptoms [5].

In addition, both alcohol and tobacco use have been associated with an increased risk of developing heartburn symptoms. Alcohol can relax the LES, allowing stomach acid to flow back into the esophagus, while smoking can irritate the esophageal lining [5].

Concomitant medications

Some medications taken alongside venlafaxine may increase the risk of developing heartburn. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can irritate the lining of the stomach and esophagus, potentially leading to heartburn symptoms [6].

What to do if you experience venlafaxine-induced heartburn?

If you are experiencing persistent or severe heartburn while taking venlafaxine, it is advisable to consult with a healthcare professional for proper evaluation and guidance. 

However, some of the strategies that may help avoid or manage heartburn include:

• Appropriate dosing and administration: The safe dosing of venlafaxine depends on each patient’s condition and response, typically starting at 75 mg per day. Make sure not to ever exceed the prescribed dosage, as this increases the likelihood of experiencing such side effects.
• To prevent heartburn, it is recommended to take venlafaxine with food or immediately after a meal. 
• Eat smaller, more frequent meals, and avoid large meals that can trigger heartburn. Moreover, choose foods that are low in fat and acidity, and avoid spicy foods, citrus fruits, tomatoes, chocolate, caffeine, alcohol, and carbonated beverages.
•  Avoid lying down within 2 hours after eating.
• Slightly elevating your torso while sleeping, by placing relatively big pillows under your head, may help prevent nighttime heartburn.
• Avoid smoking and alcohol intake.
• Take over-the-counter antacids or acid reducers, such as Omeprazole.

Conclusion 

In my opinion, venlafaxine is not commonly associated with causing heartburn, but certain factors can increase the likelihood of experiencing heartburn while taking this medication. These factors include underlying gastrointestinal conditions, eating habits, concomitant medications, alcohol and tobacco use, and stress/anxiety. 

Based on my research, I have found that venlafaxine may actually be beneficial in managing heartburn in depressed patients and improving symptoms of non-erosive gastroesophageal reflux disease. However, some studies state that it does not affect heartburn. 

If someone experiences persistent or severe heartburn while taking venlafaxine, I recommend that they consult with a doctor for advice on appropriate dosing and administration, dietary modifications, lifestyle changes, and the use of over-the-counter antacids to help manage their symptoms.

References