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Those who suffer from clinical depression are becoming more able to treat due to an antidepressant drug called Effexor. Effexor is one of an ever increasing number of medications to treat depression and which is proving to be one of the most promising.

Wyeth-Ayerst introduced Effexor in 1993. Effexor works on both serotonin and norepinephrine, but in a different way than the earlier tricyclics. At lower doses Effexor works mainly on serotonin, much like the SSRIs. At higher doses, it acts on norepinephrine as well.

Effexor is prescribed to treat depression which is associated with such symptoms as loss of appetite, unusual sleep habits, and fatigue, difficulty concentrating, impaired thinking, feelings of guilt or worthlessness and even suicidal thoughts. These symptoms must be present for a period of at least 6 months.

Most people with a depressive illness do not seek treatment right away, although the great majority-even those whose depression is extremely severe-can be helped. Thanks to years of research, Effexor was introduced to help fight depressive illness.

The variety and number of antidepressants is ever increasing. So how does a physician decide that Effexor is the right medication to use? According to random interviews with psychiatrists, some trial and error comes into play because certain drugs do better for certain patients but most seem to turn to Effexor.

"Usually, I will start with Effexor because of the possibility more patients will do better. I think people deserve the best shot," said Dr. Robert Bishop, a psychiatrist in private practice in Northern Virginia.

"Prozac, Zoloft and Effexor are my top choices," said Dr. Salerian, adding that with a young person, he tends to try Effexor first because it causes less drowsiness. "We don't know what is the best first-line therapy," said Dr. Stahl, senior director of Wyeth-Ayerst Clinical Research. He said Effexor seems a good medication to start with because, at lower doses, it is similar to SSRIs, and the dose can be increased instead of switching drugs. Most important, he said, is to "keep pressing, keep trying."

The recommended dose of Effexor for people with depression is 75 mg daily as a single dose. This dosage can be increased by your doctor if it proves ineffective. If you are using the tablets, the daily dose is taken in two or three divided doses with food. If you are using the long-acting capsules, the daily dose is taken in one dose with food. This dosage can be increased by your doctor if it proves ineffective. It may take several weeks before the full beneficial effects of this medication are seen.

Effexor is the only antidepressant that inhibits the reuptake of serotonin, norepinephrine, and, to a lesser degree, dopamine, increasing the level of all three neurotransmitters in the synaptic cleft. Like the SSRIs, Effexor has a relatively low side effect profile, but at high doses can cause an increase in blood pressure, a potential cause for concern in hypertensive patients. As is the case with the SSRIs, overdoses with Effexor are unlikely to cause death, especially since one of the side effects of a significant overdose is nausea and vomiting.