Is Effexor used for bipolar disorder? (+3 precautions)

In this article, we will explore whether Effexor can be taken for the treatment of bipolar disorder, how Effexor helps with bipolar disorder, what factors influence it and what are the other treatment options for treating bipolar disorder. In addition, precautionary measures for taking Effexor will also be discussed. 

Is Effexor used for bipolar disorder?

Yes, Effexor (venlafaxine) can be used for bipolar disorder. Effexor is not a first-line treatment option or FDA-approved for bipolar disorder but it can be used when other treatment options are effective.

Effexor can be used in patients with bipolar disorder who are diagnosed with depression as well. It can also be used for patients in which other first-line treatment options have not responded well.  

Effexor is not commonly prescribed for bipolar disorder because it can trigger manic episodes in patients having bipolar disorder (1). Therefore, it is usually prescribed with a mood stabiliser or antipsychotic medication. Patients taking this combination are to be carefully monitored.

Effexor is to be used cautiously and under careful supervision of a professional healthcare professional. 

How does Effexor help with bipolar disorder?

Effexor (venlafaxine) is a selective serotonin-norepinephrine reuptake inhibitor or an SNRI that is primarily used for the treatment of depression (2).

Effexor works by blocking the reuptake of these neurotransmitters thereby, increasing their levels in the brain (3). Serotonin and norepinephrine are responsible for mood regulation.  Effexor can help improve mood and reduce depression in a patient. 

In people with bipolar disorder, Effexor can help (4):

• in alleviating the symptoms of depression
• to improve mood and energy levels.
• to increase motivation and interest in activities.
• to reduce suicidal thoughts and behaviours.

When used to treat bipolar disorder, Effexor is typically used in combination with mood stabilisers such as lithium or valproate (5). Mood stabilizers help to prevent manic and depressive episodes while Effexor helps to improve mood and helps with depression.

What factors may influence the effects of Effexor for bipolar disorder?

The impact of Effexor in patients with bipolar disorder can be influenced by various factors.  Such factors include:

Individual variation: Like every other drug, the effects of Effexor also depend on individual sensitivity. The appearance of side effects, efficacy and safety of the drug, all depend upon the individual physiology. Genetics also contribute to it. 

Bipolar disorder type: The specific type of bipolar disorder plays a significant role. Effexor may be considered more cautiously in individuals having bipolar disorder I (characterized by manic and depressive episodes) as compared to bipolar disorder II (characterized by depressive and hypomanic episodes) (6).

Current mood state: The patient’s current mood state is crucial. Effexor is more commonly prescribed for managing depressive symptoms in bipolar disorders. It is generally less commonly used for manic or hypomanic states.

Concurrent medications: Patient with bipolar disorders often take mood stabilizers such as valproate or lithium or atypical antipsychotics to manage their condition. The combination of these medications with Effexor has to be carefully managed and monitored. 

Comorbid conditions: The presence of other psychiatric or medical conditions such as anxiety disorders, substance abuse, or physical health issues can affect the decision to use Effexor and may require additional medications or treatment adjustments.

Age and gender: Age and gender can influence how medications are metabolized and their effectiveness. These factors may need to be considered when determining the appropriate dosage. 

What are the FDA-approved treatment options for bipolar disorder?

The US FDA has approved several medications for the treatment of the bipolar disorder. Managing bipolar disorder usually requires a mood stabilizer, antipsychotic and in some cases antidepressants. Here is a list of FDA-approved treatment options (7).

Mood stabilizers

The FDA-approved mood stabilizers used for bipolar disorder are:

• Lithium 
• Valproate
• Carbamazepine
• Lamotrigine
• Divelproax sodium

Antipsychotics

The FDA-approved antipsychotics used for bipolar disorder are:

• Olanzapine
• Risperidone
• Quetiapine
• Aripiprazole
• Asenapine
• Lurasidone

Antidepressants

Antidepressants are generally used cautiously in bipolar disorder and are typically combined with the other two groups of medications i.e., mood stabilizers and antipsychotics. Commonly prescribed antidepressants include:

• SSRIs
• SNRIs

What are the precautions for using Effexor for bipolar disorder?

Effexor is a powerful medication and precautionary measures should be kept under consideration while using it for bipolar disorder.

• Effexor can trigger manic episodes in people with bipolar disorder so it is important to monitor the patient carefully.

• Take Effexor with mood stabilizers such as lithium or valproate to alleviate the chances of manic episodes.

• Effexor can interact with other medications and diseases. So if you have any blood pressure issues or heart issues then immediately inform your doctor. 

• It is important to start with a low dose and then gradually increase the dose to lower the risk of side effects.

• It may take several weeks for Effexor to start working and treat the symptoms of bipolar disorder. Be patient and stay in close contact with your doctor.

• Do not stop taking Effexor abruptly. It may lead to withdrawal symptoms.

• Do not take alcohol with Effexor. It can react with Effexor and increase the risk of side effects.

Conclusion

In my opinion, Effexor can be helpful in managing bipolar disorder if taken together with lithium or valproate. Effexor can have its side effects so the precautionary measure and the patient’s past medical history should be considered while prescribing it to the patient.

References