Effexor and joint pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Drugs can be associated with different side-effects. Often a drug can be suspected of both making symptoms worse as well as making those same symptoms better. Selective serotonin reuptake inhibitors (SSRIs) and other serotonergic medications are commonly prescribed medications.

A report in the Journal of Clinical Psychopharmacology (2001;21[4]:458-461) found an increase of joint pains in patients taking serotonergic medications.

Hood et al. reported on eight patients seen over a nine-month period of time. Four were treated with SSRIs (fluoxetine [Prozac], sertraline [Zoloft] and paroxetine [Paxil]), three with nefazodone (Serzone) and one with venlafaxine (Effexor). The patients had either new joint complaints or worsening of previous complaints within one week to one month after beginning the serotonergic medications. In this series, knee pain was the most frequent complaint.

The arthritis persisted in one patient who switched from sertraline to venlafaxine. The other patients recovered within one to 12 weeks. Three of the patients who recovered changed to a different antidepressant, two discontinued their antidepressant, and two continued with the original antidepressant.

Animal studies demonstrate that serotonin (5-HT) excess may worsen arthritis and its reduction may improve them.

The Committee on Safety of Medicines/ Medicines Control Agency of the United Kingdom has received 970 reports of adverse reactions from SSRIs in the musculoskeletal, connective tissue and bone-disorders system, which is 2.3% of all adverse reactions reported for SSRIs.

Alternatively, SSRIS have been used to treat the symptoms of fibromyalgia, which can also cause joint pains. So… in this instance, SSRIS are used to reduce joint symptoms.

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