Effexor®

What is Effexor?

Effexor is the brand name of the generic medication venlafaxine. Effexor is a serotonin-norepinephrine reuptake inhibitor (SNRI), which is a type of antidepressant medication that is also prescribed for anxiety. SNRIs boost the levels of both serotonin and norepinephrine (neurotransmitters that help regulate your mood) by preventing them from being reabsorbed into the nerve cells (neurons) in your brain. 

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Effexor is used to treat generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder, and social anxiety disorder (also called social phobia). It may also be prescribed for “off-label” uses for several other conditions. Off-label use is when a medication is prescribed for a condition other than one it has been approved to treat by the Food and Drug Administration (FDA). This is a common and acceptable medical practice.

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Effexor is 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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Effexor is available in immediate and extended release formulas:

Effexor/venlafaxine (immediate release) tablet

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

Effexor/venlafaxine (extended release) tablet

• 37.5 mg
• 75 mg
• 150 mg
• 225 mg

Effexor XR/venlafaxine (extended release) capsule

• 37.5 mg
• 75 mg
• 150 mg

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A typical Effexor dosage will depend on what you are taking it for, as well as which form you are taking (immediate release vs extended release). 

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If you are taking the immediate release form of Effexor for depression, a typical starting dose is 75 mg daily, taken divided up into 2 or 3 doses throughout the day. If needed, your prescribing doctor, nurse practitioner, or Minded mental healthcare professional may gradually increase your dose as needed, up to the maximum recommended dose of 225 mg or 375 mg per day, depending on the indication. (While this is the maximum recommended daily dose, some people might need a higher dose to achieve relief from their symptoms.)

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If you are taking the extended release form of Effexor for anxiety or depression, a typical starting dose is 75 mg, taken once daily (in the morning or the evening). As with the immediate release, 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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A typical starting dose of the extended release form of Effexor for panic disorder is 37.5 mg, taken once a day (morning or evening). And the maximum recommended daily dose is 225 mg per day as well.

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No matter what your dosage may be, Effexor can be taken with or without food. While the immediate release form is usually taken in divided doses throughout the day, Effexor XR is typically taken once a day (morning or evening—you will want to choose the same time each day).

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

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Effexor side effects, warnings, and interactions

Effexor side effects

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
• Shaking/tremors
• Sweating
• Trouble sleeping or changes in sleep habits
• Unusual dreams
• Yawning

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

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Talk to your prescribing doctor, nurse practitioner, or Minded psychiatric 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)
• Changes in taste
• Increased heart rate
• Increased salivation
• Irregular menstrual cycle (periods)
• Low blood pressure
• Low sodium levels in your blood (symptoms include: headaches, feeling weak, or having a hard time concentrating or remembering things)
• More frequent urination and/or difficulty urinating
• 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.)
• Teeth grinding

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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) 

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

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Effexor warnings

Effexor comes with an FDA “Black Box” warning. This means that the FDA has identified certain serious safety risks that may occur when taking this medication. “Black Box” warnings are serious safety warnings—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 (under age 24) 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 pregnancy

Discuss your treatment plan with your prescribing doctor or nurse if you are planning on becoming pregnant or breastfeeding. SNRIs (such as Effexor)—as well as other antidepressant medications—may affect your baby during pregnancy and can also be passed to them through your breast milk.

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Effexor withdrawal symptoms

If you need to stop taking Effexor for any reason, work with your prescribing doctor or nurse to develop a plan to do so carefully to gradually decrease your dose in order to avoid antidepressant medication withdrawal symptoms. These symptoms may be mild and last a week or two, or they may be more severe and last for weeks or 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 interactions

Always let your doctor or a 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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Effexor and alcohol

You should not drink alcohol if you are taking Effexor (or other antidepressant medications). While alcohol may seem to boost your mood in the short term, it can actually worsen mental health symptoms in the long term. Alcohol can decrease the positive effects of antidepressant medications while increasing the negative effects. There is also a risk of unintentionally 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

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Effexor and other SNRI medications must be taken regularly both to effectively treat depression and/or anxiety and to avoid withdrawal symptoms. You should not skip doses of Effexor to drink alcohol.