Glossary · Treatments

Venlafaxine

Also called: Effexor.

Definition: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) used off-label for vasomotor symptoms. At 37.5–75 mg/day, it reduces hot flash frequency by roughly 50% in randomized trials, making it one of the more effective non-hormonal options. It is particularly useful for women on tamoxifen, since unlike paroxetine it does not significantly inhibit CYP2D6.

Detailed definition

Venlafaxine is an SNRI that has been studied extensively for menopausal vasomotor symptoms. RCTs show roughly 50% reduction in hot flash frequency at 37.5–75 mg/day, with diminishing additional benefit at higher doses. It is widely considered the most effective non-hormonal option for hot flashes alongside fezolinetant and remains a favored choice for breast cancer survivors on tamoxifen because it does not significantly inhibit CYP2D6 (unlike paroxetine). Side effects include nausea (often resolves over 1–2 weeks), dry mouth, sweating (paradoxical), elevated blood pressure at higher doses, and discontinuation symptoms with abrupt stopping. The desvenlafaxine metabolite is also studied for VMS.

Why it matters in menopause

For breast cancer survivors on tamoxifen who need hot flash relief and cannot use estrogen, venlafaxine is often the first choice. Many ClearedRx patients with mood-plus-VMS overlap also do well on venlafaxine, with the antidepressant effect being a useful bonus.

Sources

External references: Wikipedia.

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