Treatment with Venlafaxine, also known as Efexor

The medication 

Venlafaxine was developed to treat depression, but it has also proven effective for chronic tension-type headache. You are therefore not taking this medication for its antidepressant effect, but because venlafaxine may hopefully improve your headaches. 

Mechanism of action 

Venlafaxine increases the concentration of pain-relieving substances in the body. Venlafaxine does not eliminate the headache. A realistic treatment goal is a 20% reduction in headache frequency, though the effectiveness of the medication varies significantly from person to person.

Side effects 

The most common side effects are fatigue, weight loss, dry mouth, abdominal pain, nausea, vomiting, dizziness, reduced libido, and sleep disturbances. 

Precautions 

Venlafaxine must not be taken concurrently with MAO inhibitors (e.g., Marplan). 

Thorough tooth brushing and regular dental check-ups are important, as dry mouth increases the risk of cavities. 

Before starting treatment

Before you begin treatment, an electrocardiogram (ECG) must be performed.

What is the recommended dosage 

Typically, you start by taking 75 mg at bedtime for one week. After that, the dose is increased to 150 mg at bedtime. The capsules must NOT be split. If there is no effect after 1-2 months, it can be concluded that Venlafaxine does not work for you. You should then taper off by 75 mg per week and subsequently stop taking the medication. If there is a good effect and no bothersome side effects, this dose is taken for 6 to 12 months, after which the dose can be tapered off in consultation with your doctor. Some patients, however, may need to take venlafaxine for a longer period.