Venlafaxine
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Venlafaxine: From Depression and Anxiety Disorders to Ohdo Syndrome and Variants
One-Sentence Summary
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI), originally used to treat depression and anxiety disorders. The TxGNN model predicts it may be effective for Ohdo syndrome and variants, a rare genetic disorder. No clinical trials and no publications currently support this prediction, so it is a computational signal only.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Depression and anxiety disorders (unipolar depression, major depressive disorder, anxiety disorder, social phobia, phobic disorder; taken from the knowledge-graph indication list because the Singapore licence records carry no indication text) |
| Predicted New Indication | Ohdo syndrome and variants |
| TxGNN Prediction Score | 95.86% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 7 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available in the data compiled for this report. Venlafaxine is known to be an SNRI. It blocks serotonin reuptake and, at higher doses, norepinephrine reuptake. Its efficacy in depression and anxiety disorders is well established.
The link to the predicted indication is weak. Ohdo syndrome is a rare genetic disorder (KAT6B-related) with intellectual disability and blepharophimosis (narrow eyelid openings). It is not a monoaminergic disorder, and no known pathway connects SNRI pharmacology to its underlying biology. The same applies to the closely related entries "blepharophimosis - intellectual disability syndrome, Ohdo type". These are likely neighbouring-node artefacts in the knowledge graph, not independent signals.
The high score reflects graph-based pattern matching, not pharmacological or clinical reasoning. On the available information, this prediction should be treated as unsupported.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
Venlafaxine has 7 valid single-ingredient registrations in Singapore, all oral. The first 5 are listed below. Approved indication text is not available in the licence records.
| Authorization Number | Product Name | Dosage Form |
|---|---|---|
| SIN11435P | EFEXOR XR CAPSULE 75 mg (Pfizer Ireland Pharmaceuticals) | Capsule |
| SIN15038P | VENLEX XR CAPSULES 75MG (Pharmathen) | Capsule, extended release |
| SIN15039P | VENLEX FORTE XR CAPSULES 150MG (Pharmathen) | Capsule, extended release |
| SIN15521P | DEPREVIX MODIFIED RELEASE HARD CAPSULE 150MG (Pharmathen) | Capsule, delayed release |
| SIN15520P | DEPREVIX MODIFIED RELEASE HARD CAPSULE 75MG (Pharmathen) | Capsule, delayed release |
Safety Considerations
- Package insert warnings and contraindications: Not available in the data compiled for this report. Please refer to the package insert for safety information.
- Disease-level contraindications (knowledge-graph associations, not label text):
- Cardiovascular: hypertension, long QT syndrome (including familial), cardiovascular and heart disease, cerebrovascular disorder.
- Liver and kidney: liver failure, liver disease, cirrhosis, impaired renal function, gallbladder disease.
- Neurological and psychiatric: epilepsy, bipolar disorder and major affective disorder, neuroleptic malignant syndrome.
- Eye: angle-closure glaucoma, ocular hypertension.
- Endocrine and metabolic: hyperthyroidism (Graves disease, thyrotoxicosis), hypertriglyceridemia, inappropriate ADH syndrome.
- Other: blood coagulation disease, substance-related disorders and drug dependence, interstitial lung disease.
- Drug interactions: 100 interactions were recorded. Those flagged Major among the entries reviewed:
- Bupropion
- Lorcaserin
- Diethylpropion
- Phentermine
- Dolasetron
- Palonosetron
Moderate-level examples include aspirin, morphine, epinephrine, clarithromycin, famotidine, loperamide, and aprepitant.
- Population concern: Ohdo syndrome mainly affects children, and no paediatric safety or efficacy data exist for this use.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction rests only on a graph-based score, with no trials, no publications, and no plausible mechanistic link between SNRI pharmacology and KAT6B-related pathology. Paediatric safety is an additional concern.
To proceed, the following is needed:
- A credible mechanistic hypothesis, ideally supported by preclinical or cell-based data.
- Detailed mechanism of action data and the Singapore package insert warnings and contraindications.
- A paediatric safety assessment.
Note: Other predictions from the same analysis have far more support and may be better candidates to pursue first:
- Dysthymic disorder (L2): a meta-analysis and several venlafaxine-specific studies.
- Obsessive-compulsive disorder (L1): double-blind RCTs against paroxetine and a large pragmatic trial in progress.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.