Venlafaxine

Indication

A new class of antidepressant medications, unrelated to the tricyclic antidepressants, used in the treatment of depression.

Side effects

Anxiety, somnolence, dizziness, dry mouth, nausea, abnormal ejaculation (male), impotence, headache, tremor, blurred vision, asthenia, sweating, nervousness, hypertension, and insomnia have been the most commonly reported. Changes in weight, appetite and allergic reactions have also been reported more infrequently. Other less common effects include infection, chills, chest pain, tachycardia, rash, constipation, abnormal dreams, paraesthesias, depression, urinary retention, twitching, change in taste, and tinnitus.

Interactions and precautions
1. Use with caution and at a reduced dosage in those with, liver impairment.
2. Consider overall risk-benefit in those with hypertension.
3. Do not use with alcohol.
4. Do not use with Mao inhibitors--fatal interaction can result.
5. Potential for interaction with over-the-counter cold remedies, consult you physician before use.
6. Use with cimetidine could potentiate the effects of venlafaxine. A dosage reduction (venlafaxine) may be necessary in some individuals.

Usual dose

Adults: oral, 75 mg per day in two to three dicided doses, taken with food.

hydromorphone

Indication

A narcotic pain medication used to relieve pain.

Side effects

Sedation, decreased senses, dizziness, seizures, euphoria, low blood pressure, decreased heart rate, nausea, vomiting, constipation, ¯ paralytic ileus, urine retention (cannot void), respiratory depression (slowed breathing), and addiction.

Interactions and precautions
1. Use with alcohol tricyclic antidepressants, sedatives, other narcotic pain medications, antihistamines, muscle relaxants, or other depressants can increase sedation.
2. Use with anticoagulants; (Warfarin) may increase anticoagulant effect.

Usual dose

Adults: oral, 2 mg every three to six hours as needed. Paediatrics: individualized by physician.