Venlafaxine and severe respiratory disorders Introduction Venlafaxine is a serotonin and noradrenalin reuptake inhibitor that was approved for marketing in 1994. In the past years, the number of prescriptions for the drug

Introduction Venlafaxine is a serotonin and noradrenalin reuptake inhibitor that was approved for marketing in 1994. In the past years, the number of prescriptions for the drug have gradually increased (Figure 1). The drug is indicated for the treatment of depression, especially when accompanied by vital signs, and for the treatment of generalised anxiety disorder [1]. The most frequently reported ADRs are nausea, somnolence, dry mouth, insomnia, dizziness, constipation, weakness, nervousness, and sweating [2]. Disorders of the respiratory tract mentioned in the Summary of Product Characteristics (SPC) are: gasping, pharyngitis, rhinitis and sinusitis. Recently, the possible relationship between venlafaxine and interstitial pneumonitis has received some media attention. This attention was raised by a case report in the American Journal of Respiratory and Critical Care Medicine [3]. The Netherlands Pharmacovigilance Centre Lareb has received one of the two cases described in that art icle. In total, our centre has received four reports on severe respiratory disorders, but the possibility of such an association is not mentioned in the Dutch SPC of venlafaxine. Basically, two different types of pulmonary adverse reactions associated with venlafaxine seem to exist: eosinophilic pneumonia and non-eosinophilic pneumonitis[4].