Venlafaxine Helps Non-Cardiac Episodic Sternal Chest Pains in Young People

There is a condition where intermittent sternal chest pains, angina like in character, develop.These develop in young people and workups are negative. Esophageal hypersensitivity has been shown to exist in these cases. Venlafaxine has been shown to help.

Am J Gastroenterol. 2010 Mar 23. [Epub ahead of print]
Efficacy of Venlafaxine for Symptomatic Relief in Young Adult Patients With Functional Chest Pain: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.
Lee H, Kim JH, Min BH, Lee JH, Son HJ, Kim JJ, Rhee JC, Suh YJ, Kim S, Rhee PL.
abstract here

  • both peripheral and central sensitization occurs
  • low dose trazadone or imipramine has been previously shown helpful
  • 20 – 29 years of age with at least 3 attacks per week of unexplained midline chest pain, over 3 months
  • Effexor XR 75 mg 2-3 hours before bedtime

Results – over 5 week period, symtoms intensity scores were reduced 50% compared with placebo.

Comment – Venlafaxine has been proven some help certain pain conditions:

  • Diabetic peripheral neuropathy – brings pain down from 7.2/10 to 3.1/10 versus from 7.4/10 to 5.5/10 in placebo:

J Diabetes Complications. 2008 Jul-Aug;22(4):241-5. Epub 2008 Apr 16.The effect of venlafaxine HCl on painful peripheral diabetic neuropathy in patients with type 2 diabetes mellitus.
Kadiroglu AK, Sit D, Kayabasi H, Tuzcu AK, Tasdemir N, Yilmaz ME. abstract here

  • Tension headache – helps 1/3.48 cases at 150 mg:
    Cephalalgia. 2007 Apr;27(4):315-24. Epub 2007 Mar 7.
    A randomized, double-blind, placebo-controlled study of venlafaxine XR in
    out-patients with tension-type headache.
    Zissis NP, Harmoussi S, Vlaikidis N, Mitsikostas D, Thomaidis T, Georgiadis G,
    Karageorgiou K. abstract here
  • Chemotherapy induced neuropathy – both venlafaxine and topiramate were found effective
    Anticancer Drugs. 2005 Jun;16(5):587-91.
    Clinical activity of venlafaxine and topiramate against oxaliplatin-induced disabling permanent neuropathy.
    Durand JP, Alexandre J, Guillevin L, Goldwasser F. abstract here
  • Migraine – at 150 mg
    Headache. 2005 Feb;45(2):144-52.
    The efficacy and safety of venlafaxine in the prophylaxis of migraine.
    Ozyalcin SN, Talu GK, Kiziltan E, Yucel B, Ertas M, Disci R. abstract here

However, Venlafaxine did NOT work for “functional dyspepsia”:

Clin Gastroenterol Hepatol. 2008 Jul;6(7):746-52; quiz 718. Epub 2008 Apr 18.
Effect of the antidepressant venlafaxine in functional dyspepsia: a randomized, double-blind, placebo-controlled trial.
van Kerkhoven LA, Laheij RJ, Aparicio N, De Boer WA, Van den Hazel S, Tan AC,
Witteman BJ, Jansen JB. abstract here

The fact it helps here is helpful.

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