Does Venlafaxine cause muscle twitches? (5+ tips)
By
Dr Kirti Hira PhD
| Reviewed by
Ivan Kahwa
The contents of this article are fact-based except otherwise stated within the article.
Author bio
Dr Kirti Hira is a medical writer with expertise in Pharmacology and conducting systematic literature reviews (SLR). She writes and reviews content on pharmaceutical drugs.
Dr Kirti Hira’s Highlights:
- Associate consultant at IQVIA, India
- PhD in Pharmacy with a focus on the Discovery of Pro-inflammatory cytokine inhibitors from bacterial strain of Pseudomonas aeruginosa at the BITS-Pilani, Hyderabad campus, India
- Master’s in Pharmacology with a focus on the development of a new acute pancreatitis model at the NIPER, Mohali, India
Professional Experience:
Dr Kirti Hira joined IQVIA, India as soon as she completed her doctoral degree.
Dr Kirti Hira was involved in performing a systematic literature search and gap analysis to support the development of a clinical evaluation report (CER) and performance evaluation report (PER) as per EU MDR (European Medical Device Regulations) and/or EU IVDR (European In-Vitro Device Regulations).
In addition to this, she has also supported the development of a literature search strategy, reviewed and appraised the literature critically, and prepared systematic literature review (SLR) reports to identify the potential risks, safety trends, and off-label uses to ensure that the medical device safety profile is aligned with safety and marketing claims.
Dr Kirti Hira has contributed to screening, analyzing, and reviewing the published literature and clinical investigation results to evaluate the safety and performance of medical devices and pharmaceutical drugs.
Education:
- 2014 Bachelor of Pharmacy at the Delhi Institute of Pharmaceutical Sciences and Research (DIPSAR), New Delhi, India
- 2016 Master of Science, Pharmacology at the National Institute of Pharmaceutical Education and Research (NIPER), Mohali, India
- 2021 PhD in Pharmacy at BITS-Pilani, Hyderabad campus, India
The main Publications of Dr Kirti Hira are:
Articles:
- Hira, K., Sharma, P., Mahale, A., Kulkarni, O. P., & Begum, A. S. (2022). Cyclo (Val-Pro) and Cyclo (Leu-Hydroxy-Pro) from Pseudomonas sp.(ABS-36) alleviates acute and chronic renal injury under in vitro and in vivo models (Ischemic reperfusion and unilateral ureter obstruction). International Immunopharmacology, 103, 108494.
- Hira, K., Shaik, A., Kumar, S., & Ahil, S. B. (2017). Pseudomonas Potential Source for Drug Lead Discovery. Current Trends in Biomedical Engineering & Biosciences, 5(5), 108-111.
- Ahil, S. B., Hira, K., Shaik, A. B., Pal, P. P., Kulkarni, O. P., Araya, H., & Fujimoto, Y. (2019). L-Proline-based-cyclic dipeptides from Pseudomonas sp.(ABS-36) inhibits pro-inflammatory cytokines and alleviates crystal-induced renal injury in mice. International Immunopharmacology, 73, 395-404.
- Kumar, S. S., Hira, K., Begum Ahil, S., Kulkarni, O. P., Araya, H., & Fujimoto, Y. (2020). New synthetic coumarinolignans as attenuators of pro-inflammatory cytokines in LPS-induced sepsis and carrageenan-induced paw oedema models. Inflammopharmacology, 28, 1365-1373.
- Begum, S. A., Hira, K., Pal, P. P., Nessa, S., Kulkarni, O. P., Danaraj, J., … & Fujimoto, Y. (2021). Halodule pinifolia (Seagrass) attenuated lipopolysaccharide-, carrageenan-, and crystal-induced secretion of pro-inflammatory cytokines: mechanism and chemistry. Inflammopharmacology, 29, 253-267.
- Kumar, S. S., Begum, A. S., Hira, K., Niazi, S., Kumar, B. P., Araya, H., & Fujimoto, Y. (2019). Structure-based design and synthesis of new 4-methyl coumarin-based lignans as pro-inflammatory cytokines (TNF-α, IL-6 and IL-1β) inhibitors. Bioorganic Chemistry, 89, 102991.
- Begum, A. S., Kumar, S. S., Gottapu, S., & Hira, K. (2018). O-Glucoside of natural cleomiscosin-A: An attenuator of pro-inflammatory cytokine production. Phytochemistry Letters, 26, 83-87.
- Sanjana, P., Kirti, H., & Begum, A. S. (2016). Medical devices and their approval procedure in India. International Journal of Drug Regulatory Affairs, 4(3), 19-29.
Book Chapter:
- Hira, K., & Sajeli Begum, A. (2021). Methods for evaluation of TNF-α inhibition effect. The TNF Superfamily: Methods and Protocols, 271-279.
Conference papers:
- Cyclo (Val-Pro) attenuates renal injury by inhibiting pro-inflammatory cytokines in mice renal ischemic model. Cytokines 2019- International Cytokines and Interferon Society, Vienna, Austria. Oct 20-23,2019.
- Natural Diketopiperazines as TNF-α and IL-6 inhibitors. Pharmacology 2018 British Pharmacological Society, London, UK. Dec 18 – 20, 2018.
- HDAC5/KLF2 axis regulates NLRP3-mediated renal inflammation and fibrosis associated with nephrocalcinosis-related chronic kidney disease. Nephrology Dialysis Transplantation, 35(Supplement_3), 2020
- Tumor Necrosis Factor-alpha inhibitory activity of H.pinifolia. 24th ISCB International Conference, Manipal University, India. 11-13th Jan 2018.
- Bioactive cyclic dipeptides of microbial origin in discovery of cytokine inhibitors. International Conference on Drug Development Technology (Dubai), Oct 16-17, 2017, 19(10) Part VIII, 888.
- MTT assay-guided isolation of a cytotoxic lead from Hedyotic umbellate and its mechanism of action against non-small cell lung cancer A549 cells. International Conference on Drug Development Technology (Dubai), Oct 16-17, 2017, 19(10) Part VIII, 891.
- Screening of phyto-compounds to identify cytotoxic lead molecules against A549, MDA- MB and HT-29 cell lines and their isolation methods. 68th Indian Pharmaceutical Congress, 2016, Dec 16-18, Visakhapatnam.
You can view Dr Kirti’s work below and links to her professional profiles.
Research Gate:https://www.researchgate.net/profile/Kirti-Hira
LinkedIn:https://in.linkedin.com/pub/kirti-hira/a3/975/549
Google Scholar:https://scholar.google.com/citations?user=hlbrGn4AAAAJ&hl=en
Reviewer bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will explore whether Venlafaxine causes muscle twitches or not. Additionally, we will discuss the research studies that discuss the link between Venlafaxine and its motor side effects. What factors influence Venlafaxine-induced muscle twitches and how we can manage and minimize muscle twitching while taking Venlafaxine? Furthermore, we will discuss alternative treatment options, if twitching persists.
Does Venlafaxine cause muscle twitches?
Yes, Venlafaxine can cause a twitch in your muscles.
Venlafaxine is an FDA-approved serotonin-norepinephrine reuptake inhibitor (SNRI) widely prescribed for the treatment of depression, cataplexy, social anxiety disorders and generalized anxiety disorders. It works by regulating serotonin, norepinephrine and dopamine levels in the brain.
Venlafaxine is regarded as a very potent serotonin reuptake inhibitor. Upregulated levels of serotonin in the brain may lead to increased involuntary muscular movement or twitching (1).
What does research suggest?
According to a case report, a 25-year-old female with migraine experienced agitation, twitching in both legs, shaking and sweating within an hour of Venlafaxine administration. Symptoms resolved after three hours of IV fluid administration (2).
In another incidence, tremors in the upper and lower extremities along with muscular twitching were reported by an 18-year-old female patient with generalized anxiety disorder on Venlafaxine administration (3).
How does Venlafaxine induce muscle twitching?
Muscle twitching can be described as sudden involuntary muscle fasciculations that can happen in any part of the body. Venlafaxine can induce muscle twitching in the following ways:
Upregulated Serotonin levels
Venlafaxine increases serotonin levels in the brain by preventing its reuptake at the presynaptic nerve terminals. Elevated serotonin affects nerve and brain cells. This further impacts muscle control and results in abnormal muscular movements (4).
Alteration of other neurotransmitter level
Also, Venlafaxine upregulates the level of other neurotransmitters (Norepinephrine and Dopamine) that stimulate the central nervous system. This effect can also lead to muscle fasciculations.
What factors influence Venlafaxine-induced muscle twitches?
Venlafaxine is generally regarded as a safe antidepressant medication with common side effects such as nausea, dizziness, loss of appetite, weight loss, sexual problems, difficulty in urination, acid reflux, bloating, and stomach pain.
While it is not common to experience muscle twitching with Venlafaxine, several factors can contribute to this side effect, including:
Venlafaxine dose: Increased dosage or taking Venlafaxine for a longer duration can result in a life-threatening condition known as Serotonin syndrome which involves involuntary muscle movements and hyperactive reflexes. It can also occur if medication is taken along with other drugs that increase serotonin levels.
Neurological Diseases: Venlafaxine can exacerbate muscle twitches in patients with neurological disorders such as Parkinson’s disease and Tourette syndrome.
Other factors: Other factors that can contribute to muscle twitching include dehydration, stress and anxiety, nutrient deficiency of vitamin D, vitamin B and calcium, inadequate sleep, increased uptake of CNS stimulants such as amphetamine and caffeine, and medications such as estrogen pills and corticosteroids.
Tips to manage and minimize Venlafaxine-related muscle twitches
If you experience muscle twitching on Venlafaxine medication, it is important to consult your doctor. The physician will determine the underlying cause by assessing your symptoms and will guide you through the best course of treatment which might include:
- Eating a well-balanced diet to prevent any nutrient deficiency.
- Staying well-hydrated.
- Practising yoga and meditation for stress relief.
- Getting adequate sleep.
- Adjusting Venlafaxine dose.
- Avoiding CNS-stimulant such as caffeine
- Some medications such as corticosteroids and estrogen can also result in muscular twitching. Such medicine should be avoided with Venlafaxine.
- Switching to some other antidepressant to minimize the side effects
What are the alternative treatment options, if twitching persists?
Switch Medication: If you experience consistent twitching with Venlafaxine medication, you should immediately contact your healthcare provider for a change of medication.
Depending on the underlying causes, treatment can be shifted from SNRI to SSRIs such as Lexapro, or to NDRIs like Wellbutrin, where muscle twitching is a very rare side effect.
Alternative therapies: If antidepressants are causing persistent side effects, you can try alternative therapies such as Cognitive behavioural therapies and mindfulness techniques. Such techniques help to calm your mind and relieve symptoms of anxiety and depression.
Practising yoga and meditation can also help you in providing relief from stress and anxiety.
Treatment for muscle twitching: Medications such as Neuromuscular blockers and muscle relaxants can help you with muscle twitches.
Conclusion
In my opinion, Venlafaxine can cause muscle twitching by altering your serotonin levels and the severity may vary from person to person. The condition can be easily managed by diagnosing at an early stage and starting treatment immediately.
Most cases can be managed either by switching to other drugs or by lowering the dosage. In either case, proper consultation with the healthcare provider is required as stopping medication abruptly could lead to life-threatening side effects.
Was this helpful?
References
1.-
Venlafaxine: MedlinePlus Drug Information [Internet]. medlineplus.gov. 2022. [Updated 2022 Jan 15; Cited 2023 Nov 04]. Available from: https://medlineplus.gov/druginfo/meds/a694020.html
2.-
Diamond S, Pepper BJ, Diamond ML, Freitag FG, Urban GJ, Erdemoglu AK. Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports. Neurology. 1998 Jul;51(1):274-6. doi: 10.1212/wnl.51.1.274. PMID: 9674820.
3.-
Hawthorne JM, Caley CF. Extrapyramidal Reactions Associated with Serotonergic Antidepressants. Ann Pharmacother. 2015 Oct;49(10):1136-52. doi: 10.1177/1060028015594812. Epub 2015 Jul 16. PMID: 26185277.
4.-
Singh D, Saadabadi A. Venlafaxine: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. [Updated 2022 Oct 10, Cited 2023 Nov 04]. In Available from: https://www.ncbi.nlm.nih.gov/books/NBK535363/
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