Venlafaxine Vs. Zoloft: Drug Comparison

Venlafaxine is the active ingredient in the brand-name medication Effexor XR^®. The information below is about brand name Effexor XR. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

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.

Zoloft^® (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial treatment period.

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)

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• Typically taken orally once daily

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

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

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 (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• 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

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• 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

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal in the neonate

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

Antidepressants 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.

*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, may also be 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 label for brand name Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.