Effexor (Venlafaxine)

What is Effexor XR?

Effexor XR is a prescription-only medication used to treat mental health conditions, including depression and anxiety.

It belongs to a class of medications known as selective serotonin and norepinephrine reuptake inhibitors (SNRIs).

Effexor XR comes in capsule form in the following dose formats: 37.5mg, 75mg, and 150 mg.¹

Venlafaxine ER is the low-cost generic version of this drug.

Generic immediate-release venlafaxine is also available. It was previously sold as Effexor. The Effexor product has been discontinued,² but Effexor XR is still available.

What is Effexor XR used to treat?

Effexor XR is approved to treat the following conditions:³

• Major depressive disorder

• Generalized anxiety disorder

• Social anxiety disorder

• Panic disorder

The drug works by increasing serotonin and norepinephrine levels in the brain to improve mood and decrease symptoms.

How do you take Effexor XR?

Your doctor will prescribe an Effexor XR dose based on:

• The nature and severity of your condition

• Any other medical conditions you may have

They may prescribe a low dose to start with, then modify it over time to establish which dose works best for you.

Typical Effexor XR doses are given below for each condition it’s prescribed for.³

Major depressive disorder

What You Need to Know About Major Depressive Disorder

• Starting dose: 37.5–75mg daily

• Target dose: 75mg daily

• Maximum dose: 225mg daily

Generalized anxiety disorder

What You Need To Know About Generalized Anxiety Disorder

• Starting dose: 37.5–75mg daily

• Target dose: 75mg daily

• Maximum dose: 225mg daily

Social anxiety disorder

What You Need To Know About Social Anxiety

• Starting dose: 75mg daily

• Target dose: 75mg daily

• Maximum dose: 75mg daily

Panic disorder

What Is Panic Disorder: Everything You Need To Know

• Starting dose: 37.5mg daily

• Target dose: 75mg daily

• Maximum dose: 225mg daily

Your doctor will prescribe a dose that is safe for you. Follow their advice closely.

Take this drug consistently to maximize its effectiveness. To aid your memory, take it at the same time each day.

Seeing results

Some people see results within a week or two, but some take longer.⁴ If you don’t see any improvement after four to six weeks, your doctor may increase your dose or suggest a different medication.

Potential side effects of Effexor XR

Like all drugs, Effexor XR can cause side effects. Some are more serious than others and require medical attention.

Common side effects of Effexor XR

Common side effects that occur with Effexor XR include:⁵

• Dizziness

• Drowsiness

• Fatigue

• Headache

• Tremors

• Difficulty sleeping

• Unusual dreams

• Feeling anxious, jittery, or nervous

• Rapid heartbeat

• Blurred vision

• Increased sweating

• Nausea or vomiting

• Diarrhea or constipation

• Unexplained weight changes

• Changes in appetite

• Dry mouth

• Yawning

• Sexual problems

Speak to your doctor if any of these common side effects continue, worsen, or bother you.

Serious side effects of Effexor XR

Effexor XR can also cause serious side effects, including:

• Trouble breathing, coughing, or a tight feeling in your chest

• Seizure

• Signs of eye problems: blurry vision, eye redness, eye pain, or seeing halos around lights

• Unusual bleeding (bleeding gums, nosebleeds, or abnormal vaginal bleeding) or bleeding that won’t stop

• Signs of low blood sodium levels: confusion, headache, memory problems, or unsteadiness

• Signs of severe nervous system reaction: stiff muscles, tremors, fast or uneven heartbeat, sweating, high fever, feeling faint, or confusion

This medication can raise your risk of suicidal thoughts and actions,⁶ especially during the first months of treatment or after a dosage change. This is most common in teens and young adults.

Contact your doctor if you notice changes in your mood, behavior, thoughts, or feelings.

Effexor XR can also cause serotonin syndrome, a potentially life-threatening condition. Symptoms of serotonin syndrome include:

• Fever

• Sweating

• Shivering

• Nausea

• Vomiting

• Diarrhea

• Twitching

• Stiff muscles

• Fast heart rate

• Loss of coordination

• Agitation

The drug may also cause an allergic reaction. You might experience itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, or trouble breathing.

You must seek urgent medical help if you develop serious side effects, including symptoms of serotonin syndrome and an allergic reaction.

Long-term use of Effexor XR

Effexor XR is generally considered safe for long-term use.⁷

Some people report experiencing sexual problems like reduced sex drive and difficulty getting an erection with long-term venlafaxine use.

If you have been taking Effexor XR for an extended period of time and you are experiencing any unwanted side effects, talk to your doctor. They may decide to adjust your dose or switch you to a different medication.

Don’t stop taking Effexor XR suddenly, as this can cause withdrawal symptoms.

Missed doses

If you forget to take a dose of Effexor XR, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.

Do not take two doses of Effexor XR at the same time.

Overdoses

Taking an overdose of Effexor XR can cause the following symptoms:⁸

• Nausea

• Vomiting

• Dizziness

• Sleepiness

• Muscle pain

• Feeling hot or cold

• Seizure

• Fast, slow, or irregular heartbeat

• Increased pupil size

• Tingling, numbness, or a burning sensation in your hands and feet

• Coma

Get emergency medical help if you think you or someone else has taken too much Effexor XR.

Allergy information

Effexor XR may cause a serious skin reaction. Symptoms may include:⁵

• Hives or skin rash

• Swelling of your face, lips, tongue, or throat

• Difficulty breathing

Get medical help immediately if you develop any of these symptoms, and stop taking the medication.

What to discuss with your doctor before taking Effexor XR

Before taking Effexor XR, tell your doctor if:

• You are allergic to this drug or others. Tell your doctor if you have had an allergic reaction to venlafaxine.

• You take other medications. Provide your doctor with a list of prescription and nonprescription medications, vitamins, and herbal remedies. Effexor XR interacts with several other medicines, so tell your doctor if you start or stop taking any drugs during your treatment.

• You have other medical conditions.

• You are getting non-pharmacological treatment, such as talk therapy. Your doctor can explain how these alternative therapies may work together with Effexor XR.

• You are pregnant, planning a pregnancy, or breastfeeding.

Stopping Effexor XR

It would help if you always tapered off Effexor XR with your doctor’s guidance. Stopping suddenly can cause withdrawal symptoms, including:¹⁰

• Dizziness

• Nausea

• Vomiting

• Headache

• Tiredness

• Nightmares

• A prickling or tingling sensation on your skin

Some people benefit from tapering off Effexor XR over several weeks or even months. Others only need to reduce their dose over a few days. It depends on how long you have been taking Effexor XR and the dose you’ve been taking.

Who should not take Effexor XR

Some people should not take Effexor XR. Do not take this drug if you:⁶

• Are currently taking a monoamine oxidase inhibitor (MAOI).

• Have taken MAOIs in the last 14 days.

• Are receiving antibiotic linezolid or intravenous methylene blue.

• Are allergic to venlafaxine hydrochloride, desvenlafaxine succinate, or any other ingredients in Effexor XR. You will be able to find this information in your medication booklet or ask your doctor or pharmacist.

Effexor XR and pregnancy

Effexor XR is categorized as a pregnancy category C medication according to the US Food and Drug Administration (FDA).³ It is thought that Effexor XR may cause harm to an unborn baby, but more research is needed.

Consult your doctor if you are pregnant or planning to become pregnant and wish to take an antidepressant. They can advise you on the safest course of action.

Effexor XR and breastfeeding

You may be advised to stop taking Effexor XR or stop breastfeeding. Venlafaxine has been shown to enter the breast milk and could potentially harm a nursing child.³

Interactions with other drugs

Tell your doctor about any other medications (prescription and nonprescription), supplements, and herbal medicines you are taking or plan to take before starting Effexor XR treatment. This is especially important for those taking:⁸ ³ ¹¹

• Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Emsam), tranylcypromine (Parnate), or selegiline (Eldepryl or Zelapar)

• Serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft), paroxetine (Paxil, Brisdelle, or Pexeva), or fluoxetine (Prozac)

• Lithium (Lithobid)

• Tryptophan

• St. John’s wort

• Tramadol (Qdolo or Conzip)

• Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, Midol, and others), or naproxen (Aleve, Anaprox, Naprosyn, and others)

• Blood thinners (anticoagulants), such as warfarin (Coumadin or Jantoven)

This is not an exhaustive list of possible drug interactions, so you must be transparent with your doctor before taking Effexor XR. Effexor XR can interact with other drugs and cause harmful effects.

Drug approval history

1993: The FDA approves venlafaxine to be sold under the brand name Effexor as an oral tablet (this has since been discontinued).

1997: Effexor XR is approved by the FDA in oral capsule form.

2008: Effexor XR becomes available as a generic drug (venlafaxine ER).

Tips and advice for taking Effexor XR

Here are some tips to help you have a better experience and stay safe when taking Effexor XR:

• Talk to your doctor about the possible side effects of taking Effexor XR. The medication can cause serious side effects.

• You can take Effexor XR with or without food, but taking it with food may reduce the risk of nausea.

• Avoid alcohol when taking Effexor XR.

• Effexor XR can make you feel dizzy or drowsy. Don’t drive or operate heavy machinery until you know how the drug affects you.

• Don’t stop taking Effexor XR without talking to your doctor. Stopping the medication abruptly can cause unpleasant withdrawal effects.

• Take Effexor XR exactly as prescribed by your doctor. Don’t increase or decrease the dosage.

• Be patient when taking Effexor XR. It may take a few weeks for the medication to start working properly.

• Report any changes in your mood or behavior to your doctor.