When it comes to types of medications that are often used to treat anxiety, you’ve probably heard of selective serotonin reuptake inhibitors, or SSRIs, such as Zoloft and Lexapro. You may also have heard of benzodiazepines, such as Xanax and Klonopin. Another option you may consider, though, are selective serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Effexor.

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This Minded Medication Guide will take a closer look at Effexor for anxiety to help you when talking with your prescribing doctor, nurse practitioner, or Minded psychiatry provider to choose the right medication for your treatment plan.

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Read on to learn more about this medication, including:

• What is Effexor?
• How does Effexor work for anxiety?
• What is the recommended dosage of Effexor for anxiety?
• What are some of the possible side effects of Effexor?
• How long does it take for Effexor to work for anxiety?
• How does Effexor compare to other types of anxiety medications?

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Minded Medication Guides are intended as educational aids only. They are not intended as medical advice for individual conditions or treatment. They are not a substitute for a medical exam, nor do they replace the need for services provided by medical professionals. Talk to your doctor, nurse, or pharmacist before taking any prescription medication or following any treatment or regimen.

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What is Effexor?

Effexor is the brand name of the generic medication venlafaxine. Effexor (venlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is used to treat:

• Generalized anxiety disorder (GAD)
• Major depressive disorder (MDD)
• Panic disorder
• Social anxiety disorder (also called social phobia)

It is also used off-label to treat:

• Attention deficit/hyperactivity disorder (ADHD)
• Diabetic neuropathy (nerve damage caused by diabetes)
• Hot flashes
• Migraine prevention
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (PMDD)

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Off-label use—when a medication is prescribed to treat a condition other than one it has been approved by the Food and Drug Administration (FDA) to treat—is a common and acceptable medical practice.

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How does Effexor work for anxiety?

As mentioned above, Effexor is a type of antidepressant and antianxiety medication called a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by boosting the levels of two neurotransmitters that help regulate mood—in this case, serotonin and norepinephrine—by stopping them from being reabsorbed into the neurons (nerve cells) in your brain.

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Effexor (venlafaxine) for anxiety

Effexor is available in immediate and extended release (XR) formulas:

• Effexor/venlafaxine (immediate release) tablet

• 25 mg
• 37.5 mg
• 50 mg
• 75 mg
• 100 mg

• Venlafaxine (extended release) tablet

• 37.5 mg
• 75 mg
• 150 mg
• 225 mg

• Effexor XR (extended release) capsule

• 37.5 mg
• 75 mg
• 150 mg

Effexor and Effexor XR for anxiety dosages

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If you are taking Effexor XR for anxiety (or depression), a typical starting dose is 37.5 to 75 mg, taken once daily (in the morning or the evening). Your prescribing healthcare provider may increase the dose up to the maximum recommended dose of 225 mg or 375 mg per day, depending on the indication.

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Effexor can be taken with or without food. While the immediate release version is typically taken in divided doses throughout the day, the extended release version (Effexor XR) is usually taken once a day, generally in the morning. Whether you take it in the morning or the evening is up to you—but you will want to take it at the same time each day.

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If you accidentally miss a dose of Effexor, you will want to either take the missed dose as soon as you remember, or, if it is closer to when you would take your next dose, just go ahead and take the next dose.

Common side effects of Effexor

Common Effexor and Effexor XR side effects include:

• Dizziness and/or blurred vision
• Feeling anxious, nervous, and/or jittery
• Feeling fatigued, tired, and/or overly sleepy
• Headache
• Increased blood pressure
• Increased heart rate
• Loss of appetite, constipation, diarrhea, dry mouth, or nausea/vomiting
• Nausea
• Sexual problems, including sexual dysfunction and low libido
• Shaking/tremors
• Sweating
• Trouble sleeping or changes in sleep habits
• Unusual dreams
• Yawning

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While some common adverse effects of Effexor tend to improve over the course of the first few weeks of taking this medication, other side effects—such as high blood pressure or sexual side effects—might not go away over time while you are on this medication.

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Talk to your prescribing doctor, nurse practitioner, or Minded psychiatry provider if you experience these or any other new or worsening side effects.

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Rare or serious side effects of Effexor include:

• Angle-closure glaucoma (symptoms include: eye pain, vision changes, or swelling or redness in or around your eye)
• Mania
• Seizures
• Heart arrhythmia
• Increased blood pressure
• Low sodium levels in your blood (symptoms include: headaches, feeling weak, or having a hard time concentrating or remembering things)
• Serotonin Syndrome (symptoms include: shivering, diarrhea, confusion, severe tightness in your muscles, fever, or seizures. Serotonin Syndrome is a very serious medical condition and may be fatal if not properly and promptly diagnosed and treated.)

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SNRIs—including Effexor—may increase your risk for potentially life-threatening bleeding, especially in your nose, gums, intestines, or stomach. This risk may be higher if you are also taking other medications, such as:

• Anticoagulants (such as Eliquis or Warfarin)
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen)

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Seek medical attention immediately if you experience these (or any other) serious side effects.

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Effexor warnings

Effexor (and other SNRIs) come with an FDA “Black Box Warning,” which means that the FDA has identified certain serious safety risks that may occur when taking this medication. “Black Box” warnings are serious—though the actual risk may be low or even rare.

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The Black Box warning for Effexor states:

• Children, adolescents, and young adults (24 and younger) who take antidepressants might be at an increased risk of suicidal thoughts or behaviors. Studies did not show this increased risk in people older than 24, and the risk decreased in people age 65 and older.
• Effexor is not FDA approved for use in children under the age of 18.

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Effexor and alcohol

You should not drink alcohol if you are taking Effexor (or other antianxiety or antidepressant medications). Alcohol may seem to boost your mood temporarily in the short term, but it can actually worsen your mental health symptoms in the long term. It can also increase the negative effects of your medication and decrease the positive effects. Plus, there is a risk of accidentally overdosing on Effexor if it is taken with alcohol.

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Symptoms of an Effexor overdose include:

• Abnormally fast heart rate (tachycardia)
• Changes in consciousness (including coma)
• Dilated pupils (mydriasis)
• Seizures
• Vomiting

Effexor (and other SNRI medications) must be taken regularly both to effectively treat anxiety and to avoid withdrawal symptoms.

Effexor and pregnancy

If you are pregnant, planning on becoming pregnant, or are breastfeeding, discuss your treatment plan with your prescribing doctor, nurse practitioner, or Minded psychiatry provider. SNRIs such as Effexor, as well as other similar medications, may affect your baby during pregnancy. These medications may also be passed through your breast milk when nursing.

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Effexor withdrawal symptoms

If you need to stop taking Effexor for any reason, work with your prescribing doctor, nurse practitioner, or Minded psychiatry provider to develop a plan to do so carefully in order to gradually decrease your dose. This is important to avoid withdrawal symptoms, which may be mild and last only a week or two, or could be more severe and last for weeks or even months.

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Symptoms of Effexor withdrawal may include:

• Dizziness
• Headache
• Irritability
• Nausea
• Nightmares
• Prickling and/or tingling sensation on the skin (paresthesias)
• Vomiting

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Effexor drug interactions

Always let your prescribing doctor, nurse practitioner, or Minded psychiatry provider know about any other medications and/or supplements—including over-the-counter medications and supplements as well as prescription drugs—you are taking to determine if Effexor might have any negative drug interactions with them.

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Effexor may interact with:

• Coumadin (warfarin), a blood thinner
• Medications that may cause bleeding, such as Advil (ibuprofen), aspirin, or Motrin (ibuprofen)
• Migraine medications (triptans)
• Monoamine oxidase inhibitors (MAOIs—another type of antidepressant medication)
• Selective serotonin reuptake inhibitors (SSRIs—another type of antidepressant medication)
• Some pain medications, such as Ultram (tramadol)
• Zyvox (linezolid)

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How long does it take for Effexor to work for anxiety?

You may notice your some symptoms improve within the first two weeks of starting Effexor. It may take 6 to 8 weeks (or more) for Effexor to have its full effect.

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Effexor for anxiety vs SSRIs for anxiety

As mentioned above, Effexor is a serotonin-norepinephrine reuptake inhibitor, or SNRI. Selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine) and Lexapro (escitalopram) are another type of medication that is also used to treat anxiety. As their names imply, SNRIs and SSRIs differ in the neurotransmitters that they affect: SNRIs affect both serotonin and norepinephrine, while SSRIs only affect serotonin.

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SNRIs (like Effexor) and SSRIs both:

• May begin to relieve anxiety symptoms within the first few weeks of taking these medications
• Have been found to be similarly effective in treating anxiety
• Should not be taken with alcohol

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However, there are some differences between SNRIs and SSRIs to consider as well. For instance, one study that analyzed several previous studies found that some SNRIs, like Effexor, may increase blood pressure, while SSRIs typically do not affect blood pressure.

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Effexor for anxiety vs benzodiazepines for anxiety

Benzodiazepines—such as Klonopin and Xanax—are another type of medication that can be used to treat anxiety. While Effexor (and other SNRIs) and benzodiazepines are both medication options that can be used to treat anxiety, there are some key differences to keep in mind.

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• How quickly your anxiety symptoms begin to decrease: Unlike Effexor and other SNRIs, which may take a few weeks to start working, benzodiazepines are fast-acting, with symptoms typically decreasing within hours of taking your first dose.
• How often you take the medications: While Effexor XR is a once-daily medication. Benzodiazepines can be taken every day or as needed.
• Common side effects: Both Effexor and benzodiazepines come with a risk of side effects, but the side effects for each are different.

• Common side effects of Effexor include: dizziness and/or blurred vision, anxiousness, fatigue, headage, increased blood pressure, increased heart rate, loss of appetite, constipation, diarrhea, dry mouth, nausea, vomiting, sexual problems, tremors, sweating, difficulty sleeping, unusual dreams, yawning
• Common side effects of benzodiazepines include: decreased coordination, difficulty concentrating, dizziness, drowsiness, fatigue, lightheadedness

• How long they are usually used for: While Effexor may be taken long-term, benzodiazepines are typically prescribed for short-term use (weeks or months).

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Final thoughts on taking Effexor for anxiety

If you are looking for a medication that can be taken long-term for anxiety treatment, it may be worth discussing Effexor with your prescribing doctor, nurse practitioner, or Minded psychiatric provider.

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When comparing Effexor to other common kinds of anxiety medications, it is important to remember that each type of medication comes with its own pros and cons. While there are some similarities between the different types of medications, there are also key differences. For example:

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• How often you take it: Effexor XR is taken once daily, as are most extended release SNRIs and SSRIs. Benzodiazepines, on the other hand, may be taken every day or as needed.
• How quickly symptom relief may begin: While benzodiazepines are fast-acting and may provide symptom relief within a few hours of taking them, SNRIs like Effexor (as well as SSRIs) typically take a few weeks before symptoms begin to noticeably improve.
• Whether it is safe for long-term use: Effexor (and SNRIs generally, as well as SSRIs) are typically considered safe for long-term use. Benzodiazepines are usually prescribed for short-term use. Though they are considered safe for most people who take them for anxiety, benzodiazepines are classified as controlled substances by the Drug Enforcement Administration (DEA). The risk of abuse or dependence is typically considered higher in people who have a history of substance use disorder, as well as those who take more than the prescribed dose of the medication. In addition to being safe for long-term use, SNRIs are typically not considered addictive (though abruptly discontinuing them may cause withdrawal symptoms. This withdrawal is different than potential withdrawal from benzodiazepines, which can be dangerous and even deadly).

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To find out if Effexor could work for your anxiety treatment, visit Minded to find out if you’re eligible for an online consultation. Minded offers video appointments with board-certified psychiatry providers within a week. If you’re new to mental health medication, our providers can help determine if Effexor could be a fit for you. If you already have an Effexor prescription, Minded can help you refill or renew it when appropriate. Our team of psychiatric professionals also can assist with adjusting your dose or advising you about other medications that might be a good fit for your needs.

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