Jane S. Ricciuti, RPh, MS

Disclosures

March 19, 2003

In This Article

Antidepressants

Effexor XR
(venlafaxine hydrochloride) Extended Release Capsules

Manufacturer: Wyeth-Ayerst

Drug Approval Classification: Supplemental New Drug Application (Approval Date: 02/11/03)

New Indication: Effexor XR (venlafaxine hydrochloride) is now indicated for the treatment of social anxiety disorder, also known as social phobia, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV [300.23]).

Social anxiety disorder is characterized by a marked and persistent fear of 1 or more social or performance situations that necessitate exposure to unfamiliar people or to possible scrutiny. Exposure to the feared situation usually provokes anxiety, which may approach the intensity of a panic attack. The feared situations are avoided or endured with intense anxiety or distress. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational or academic functioning, social activities or relationships, or there is a marked distress about having the phobias. Lesser degrees of performance anxiety or shyness generally do not require psychopharmacologic treatment.

Dosing: For the treatment of social anxiety disorder, the recommended starting dose for Effexor XR is 75 mg/day, administered in a single dose. In clinical trials, Effexor XR was started at a dose of 75 mg/day and the maximum dose was 225 mg/day.

The Effexor XR labeling recommends titrating the starting dose at 37.5 mg/day for 4 to 7 days, to allow new patients to adjust to the medication before increasing to 75 mg/day.

Clinical Summary: A total of 551 adult patients with social anxiety disorder were studied in two 12-week double-blind, parallel group, multicenter, placebo-controlled, flexible-dose studies. The efficacy of long-term treatment with Effexor XR beyond 12 weeks has not been studied. The dose of Effexor XR ranged from 75-225 mg/day.

Efficacy was assessed with the Liebowitz Social Anxiety Scale (LSAS). Effexor XR was significantly more effective than placebo on change from baseline to endpoint on the LSAS total score.

Adverse Effects: The most common adverse events reported in the social anxiety disorder clinical trials included: nausea (4%), insomnia (3%), headache (2%), and somnolence (2%). Impotence was reported in 3% of the men who participated in the trial (n = 158).

Effexor XR (venlafaxine hydrochloride) Extended Release Capsules Labeling

Effexor XR (venlafaxine hydrochloride) Extended Release Capsules

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