Effexor Vs. Trazodone: Drug Comparison

The information below is about Effexor XR^®, an extended-release formulation of venlafaxine. This information may not be accurate for the immediate-release formulation, Effexor^®.

Effexor XR (venlafaxine extended-release) is a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat mood disorders by increasing the available levels of serotonin and norepinephrine in the brain, which helps regulate mood and anxiety. Its FDA-approved indications include major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Off-label uses may include treatment for migraine prevention as well as treatment for premenstrual dysphoric disorder (PMDD) and neuropathic pain. Effexor XR comes in extended-release capsules, taken once daily. Common side effects include nausea, dizziness, insomnia, and sweating. It has a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the early stages of treatment.

Trazodone is an antidepressant that works by inhibiting serotonin reuptake and blocking certain serotonin receptors, helping to improve mood and alleviate symptoms of depression. Its FDA-approved indication is for the treatment of major depressive disorder (MDD) in adults. Off-label uses include treating insomnia, anxiety, and chronic pain. Trazodone is available in tablet form, typically taken once or twice daily, often at bedtime due to its sedating effects. Common side effects include swelling, drowsiness, nasal congestion, dizziness, and dry mouth. There is a risk of increased suicidal thoughts and behaviors in children, adolescents, and young adults, similar to other antidepressants.

Serotonin and norepinephrine reuptake inhibitor (SNRI)

Selective serotonin reuptake inhibitor (SSRI)

Effexor XR (venlafaxine hydrochloride) is indicated for the treatment of adults with:

• Major depressive disorder (MDD)

• Generalized anxiety disorder (GAD)

• Social anxiety disorder (SAD)

• Panic disorder (PD)

Trazodone is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 37.5 mg, 75 mg, and 150 mg extended-release capsules

• Typically taken orally in divided doses per day

• Comes in 50 mg, 100 mg, 150 mg, and 300 mg tablets

Most common adverse reactions (incidence ≥5% and at least twice the rate of placebo):

• Nausea

• Sleepiness

• Dry mouth

• Sweating

• Abnormal ejaculation

• Anorexia

• Constipation

• Impotence (men)

• Libido decreased

Most common adverse reactions (incidence ≥ 5% and twice that of placebo) are:

• Swelling

• Blurred vision

• Fainting

• Drowsiness

• Fatigue

• Diarrhea

• Nasal congestion

• Weight loss

• Hypersensitivity to venlafaxine hydrochloride, desvenlafaxine succinate, or any excipients in the Effexor XR formulation

• Concomitant use of monoaminoxidase inhibitors (MAOIs) or within 14 days of discontinuing an MAOI

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Drug interactions: CNS depressants, CYP3A4 inhibitors, CYP3A4 inducers, digoxin, phenytoin, warfarin

• Serotonin syndrome

• Elevated blood pressure

• Increased risk of bleeding

• Angle‑closure glaucoma

• Activation of mania or hypomania

• Discontinuation syndrome

• Seizures

• Low blood sodium

• Interstitial lung disease and eosinophilic pneumonia

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for symptoms of poor neonatal adaptation (respiratory distress, temperature instability, feeding difficulty, hypotonia, tremor, irritability) in the neonate

• Serotonin syndrome

• Cardiac arrhythmias

• Positional low blood pressure and fainting

• Increased risk of bleeding

• Prolonged erection

• Activation of mania or hypomania

• Potential for cognitive and motor impairment

• Angle-closure glaucoma

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric patients and young adults taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.

Effexor XR is not approved for use in pediatric patients.

WARNING: SUICIDAL THOUGHTS and BEHAVIORS

Antidepresants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Trazodone hydrochloride tablet is not approved for use in pediatric patients.

*This information is from the label for brand name Effexor XR^®. See the Full Prescribing Information for more complete information. Venlafaxine, the active ingredient in Effexor XR, is also the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient venlafaxine.

*This information is from the trazodone hydrochloride label used by Accord Healthcare, Inc. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient trazodone.