Venlafaxine-Associated Vaginal Bleeding
Venlafaxine-Associated Vaginal Bleeding
A 41-year-old amenorrheic woman started taking venlafaxine 37.5 mg/day for treatment of depression; 7 days later, she experienced vaginal bleeding, which ceased 1 day after she stopped taking the drug. On rechallenge with venlafaxine, she again experienced vaginal bleeding that resolved after discontinuation. We found no published reports describing vaginal bleeding associated with venlafaxine. However, premarketing and postmarketing data report similar adverse effects in patients taking the agent. In addition, several cases of menstrual irregularities have occurred with two other anti-depressants: fluoxetine and bupropion. This case report supports previous surveillance data indicating that venlafaxine may cause vaginal bleeding.
Venlafaxine is an antidepressant chemically unrelated to other commercially available antidepressants. It is thought to treat depression through potent inhibition of neuronal serotonin and norepinephrine reuptake and weak inhibition of dopamine reuptake. Common adverse effects, which may be dose dependent, are dizziness, nervousness, somnolence, anxiety, tremor, blurred vision, dry mouth, constipation, anorexia, nausea, abnormal ejaculation, headache, asthenia, and sweating. Premarketing and postmarketing data also indicate metrorrhagia and other urogenital effects. Pharmacologic explanations for these effects are unclear but may be related to modulation of monoamines (norepinephrine, serotonin, dopamine).
A 41-year-old amenorrheic woman started taking venlafaxine 37.5 mg/day for treatment of depression; 7 days later, she experienced vaginal bleeding, which ceased 1 day after she stopped taking the drug. On rechallenge with venlafaxine, she again experienced vaginal bleeding that resolved after discontinuation. We found no published reports describing vaginal bleeding associated with venlafaxine. However, premarketing and postmarketing data report similar adverse effects in patients taking the agent. In addition, several cases of menstrual irregularities have occurred with two other anti-depressants: fluoxetine and bupropion. This case report supports previous surveillance data indicating that venlafaxine may cause vaginal bleeding.
Venlafaxine is an antidepressant chemically unrelated to other commercially available antidepressants. It is thought to treat depression through potent inhibition of neuronal serotonin and norepinephrine reuptake and weak inhibition of dopamine reuptake. Common adverse effects, which may be dose dependent, are dizziness, nervousness, somnolence, anxiety, tremor, blurred vision, dry mouth, constipation, anorexia, nausea, abnormal ejaculation, headache, asthenia, and sweating. Premarketing and postmarketing data also indicate metrorrhagia and other urogenital effects. Pharmacologic explanations for these effects are unclear but may be related to modulation of monoamines (norepinephrine, serotonin, dopamine).
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