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Difficulty tolerating venlafaxine

Date: Wed, 5 Apr 1995 19:41:45 -0400 (EDT)
From: Charles B. Nemeroff <cnemero@emory.edu>
Subject: Difficulty tolerating venlafaxine

I find that no matter how low I start and how slowly I increase the dose, that about 25% are unable to tolerate the medciation because of nausea or other side effects.

--ivan

The key is to start very low with venlafaxine, e.g., 12.5 mg qd, and to increase very slowly. Having done that, I have little in the way of side effects. If nausea occurs, I hold at that dose and wait a few days.

Date: Fri, 09 Feb 1996 22:28:39 -0600
From: Stephen R Saklad <Saklad@uthscsa.edu>
Subject: Difficulty tolerating venlafaxine

While the usual effective doses are higher, I consulted on one patient whom we started on venlafaxine (Effexor) 37.5 qAM (in retrospect far too high for even a routine starting dose!) and who had "intolerable" side effects that afternoon. She couldn't describe them, but she didn't feel "right". After a long discussion with reassurance I persuaded her to take a half-tablet for a few days, then increase back to 18.75 mg BID. She tolerated the med without any problem within a week.

Date: Tue, 30 Apr 1996 17:46:37 -0500
From: gsdavids@niagara.com (George Davidson)
Subject: Difficulty tolerating venlafaxine

There seems to be a need to start slowly at low doses. I start them on half the 37.5 mg tablet bid for a couple of days, increasing only when it is tolerated -- I've seen a couple of rather nasty reactions from it at higher doses, and I've learned to take it slowly.

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[dr. bob] Dr. Bob is Robert Hsiung, MD, dr-bob@uchicago.edu

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