The Effects of Venlafaxine on Cognitive Functions and Quantitative EEG in Healthy Volunteers

Siepmann, Timo; Müeck-Weymann, Michael; Oertel, Reinhard; Kirch, Wilhelm; Pittrow, David; Siepmann, Martin

doi:10.1055/s-2008-1076724

Cited by 23 publications

(16 citation statements)

References 28 publications

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“…By contrast, fluoxetine, a selective serotonin reuptake inhibitor; moclobemide, a selective monoamine oxidase A inhibitor; and St John's wort extract, a herbal antidepressant, do not influence VRs. 7,16,17 The time course of the effects of venlafaxine on autonomic functions observed in the present study is in line with the known pharmacokinetics of the drug and its active metabolite O-desmethylvenlafaxine. 18 Taken as a whole, the present results show that venlafaxine may influence autonomic functions, consistent with the blockade of noradrenaline uptake when given subchronically to healthy humans.…”

Section: Discussionsupporting

confidence: 80%

The Effects of Venlafaxine on Autonomic Functions in Healthy Volunteers

Siepmann

Ziemssen²,

Müeck-Weymann³

et al. 2007

Journal of Clinical Psychopharmacology

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Antidepressants that block norepinephrine uptake may cause unwanted effects on autonomic functions such as reduction of heart rate variability. This randomized, double-blind, placebo-controlled study examined the effects of venlafaxine on heart rate variability, vasoconstrictory responses (VRs) of cutaneous blood vessels, and pupillary light reflex in humans. Twelve healthy male subjects aged 23 to 32 years (mean +/- SD, 26 +/- 3 years) orally received 37.5 mg of venlafaxine BID for 7 days and subsequently 75 mg BID for another 7 days. After a 14-day washout phase, placebo was administered to the subjects for 14 days under randomized double-blind crossover conditions. Heart rate variability was diminished, and the dilation phase of VR was prolonged during multiple dosing with venlafaxine (P < 0.05). A significant increase in resting pupil diameter, a decrease in amplitude, an increase in latency, and a shortening of the 33% recovery time of the pupillary light reflex were noted with the drug, whereas no changes were observed under placebo condition. Sustained VR and shortening of the recovery time of the pupillary light reflex are consistent with sympathetic potentiation resulting from noradrenaline reuptake blockade in cutaneous blood vessels and iris. The decrease in amplitude and increase in latency of the pupillary light reflex could be indicative of centrally mediated parasympathetic inhibition.

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Section: Discussionsupporting

confidence: 80%

The Effects of Venlafaxine on Autonomic Functions in Healthy Volunteers

Siepmann

Ziemssen²,

Müeck-Weymann³

et al. 2007

Journal of Clinical Psychopharmacology

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“…However, in an experimental setting, venlafaxine led to complex disturbances of the autonomic nervous system in a dose-dependent fashion even in the lower doses, possibly indicating a continuous dose-dependent rather than a threshold-based all or nothing mechanism of noradrenergic adverse effects (47, 48). Cognitive functions were not altered in the same expiremental setting, consistent with a predominant effect on centers of autonomic sympathetic control and efferent adrenergic pathways (49). Even though acting in a similar fashion, different adverse effects were observed for duloxetine.…”

Section: Discussionmentioning

confidence: 77%

Adverse Effects of Antidepressants for Chronic Pain: A Systematic Review and Meta-analysis

et al. 2017

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BackgroundAntidepressants are widely used in the treatment of chronic pain. Applied doses are lower than those needed to unfold an antidepressive effect. While efficacy of antidepressants for chronic pain has been reported in large randomized-controlled trials (RCT), there is inconsistent data on adverse effects and tolerability. We aimed at synthesizing data from RCT to explore adverse effect profiles and tolerability of antidepressants for treatment of chronic pain.MethodsSystematic literature research and meta-analyses were performed regarding side effects and safety of different antidepressants in the treatment of chronic pain according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The National Center for Biotechnology Information library and MEDLINE were searched. Randomized placebo-controlled trials were included in quantitative data synthesis.ResultsOut of 1,975 screened articles, 33 papers published between 1995 and 2015 were included in our review and 23 studies were included in the meta-analyses. A higher risk for adverse effects compared to placebo was observed in all antidepressants included in our analyses, except nortriptyline. The most prevalent adverse effects were dry mouth, dizziness, nausea, headache, and constipation. Amitriptyline, mirtazapine, desipramine, venlafaxine, fluoxetine, and nortriptyline showed the highest placebo effect-adjusted risk of adverse effects. Risk for withdrawal due to adverse effects was highest in desipramine (risk ratio: 4.09, 95%-confidence interval [1.31; 12.82]) followed by milnacipran, venlafaxine, and duloxetine. The most common adverse effects under treatment with antidepressants were dry mouth, dizziness, nausea, headache, and constipation followed by palpitations, sweating, and drowsiness. However, overall tolerability was high. Each antidepressant showed distinct risk profiles of adverse effects.ConclusionOur synthesized data analysis confirmed overall tolerability of low-dose antidepressants for the treatment of chronic pain and revealed drug specific risk profiles. This encompassing characterization of adverse effect profiles might be useful in defining multimodal treatment regimens for chronic pain which also consider patients’ comorbidities and co-medication.

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“…Overall, 150 mg/d moclobemide given for 3 days (N=15) [86], 150 mg/d moclobemide for 14 days (N=20) [87] and a single dose of befloxatone (20 mg, N=15) [88] showed no significant cognitive effect.…”

Section: Monoamine-oxidase Inhibitorsmentioning

confidence: 99%

Neuroenhancement in Healthy Adults, Part I: Pharmaceutical Cognitive Enhancement: A Systematic Review

Micoulaud¹

2015

J Clinic Res Bioeth

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The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through inter alia, the use of drugs. This popular topic attracts attention both from the general public and the scientific community. Our objective is to summarize in a synthetic review the data of randomized placebo-controlled trials that assessed cognitive effects of administration of neuroenhancers in non-sleep-deprived healthy adults compared to placebo. The major outcomes were attention, memory, learning, executive functions, and vigilance/wakefulness. Details on the pharmacological profile, effectiveness and safety for each drug are provided. We classify them according to their recognized major primary mode of action, namely catecholaminergics (methylphenidate,

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The Effects of Venlafaxine on Cognitive Functions and Quantitative EEG in Healthy Volunteers

Cited by 23 publications

References 28 publications

The Effects of Venlafaxine on Autonomic Functions in Healthy Volunteers

The Effects of Venlafaxine on Autonomic Functions in Healthy Volunteers

Adverse Effects of Antidepressants for Chronic Pain: A Systematic Review and Meta-analysis

Neuroenhancement in Healthy Adults, Part I: Pharmaceutical Cognitive Enhancement: A Systematic Review

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