Bipolar Disorder Treatment Medications What to Know About Effexor (Venlafaxine) An SNRI used to treat depression and anxiety By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on August 23, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Radu Bighian / EyeEm / Getty Images Venlafaxine is an antidepressant drug in a class called serotonin-norepinephrine reuptake inhibitors (SNRIs). It is an oral tablet that comes in both an immediate-release (Effexor) and extended-release (Effexor XR) formula. Both are used to treat depression in addition to a variety of other mental health conditions. SNRIs work by blocking the reabsorption (or reuptake) of serotonin and norepinephrine back into the nerve cells that released them. Blocking their reuptake increases the levels of these neurotransmitters in the brain. This improves your focus and alertness and boosts your mood. Effexor has been discontinued in the U.S., but Effexor XR is still available by prescription. Unlike Effexor, Effexor XR only needs to be taken once a day. Effexor Uses Effexor is mainly used to treat anxiety and depression. The four conditions it has been FDA-approved to treat are: Major depressive disorder (MDD) Generalized anxiety disorder (GAD) Social anxiety disorder (SAD) Panic disorder (PD) Doctors also sometimes prescribe Effexor off-label to treat other conditions, including: Attention-deficit hyperactivity disorder (ADHD) Diabetic neuropathy Hot flashes Migraines Obsessive-compulsive disorder (OCD) Premenstrual dysphoric disorder (PMDD) Post-traumatic stress disorder (PTSD) However, a 2017 study found that Effexor was one of the medications least likely to be prescribed for off-label use. One study found that Effexor was one of the most effective antidepressants. While Effexor can be a strong antidepressant, individual effects and tolerance may vary. Working with your doctor to determine which option is right for you is crucial. Common Side Effects Like any medication, side effects may occur while taking Effexor. Be sure to contact your doctor if they don't go away or become bothersome. The most common side effects include: ConstipationDiarrheaDrowsinessFeeling tiredHeadacheHeartburnLoss of appetiteNauseaSexual side effectsVomiting These side effects often improve over the first week or two as you continue taking the medication. Call your doctor if your symptoms become severe or don't go away. Effexor may make you drowsy when you first start taking it, but this side effect often goes away or improves after a week or two. Some people may also experience insomnia or nightmares. Over time, you may also notice improvements in mood and increased energy levels. Before Taking Effexor should not be taken with or within two weeks of taking monoamine oxidase inhibitors (MAOIs). Examples of MAOIs include: Emsam (selegiline)Marplan (isocarboxazid)Nardil (phenelzine)Parnate (tranylcypromine) Serious and even fatal complications may result from such a combination. Precautions Make sure your doctor knows your complete medical history. Effexor should be used with caution if you have: Brain disease, damage, or a history of seizures: The risk of seizures may increase when taking Effexor.Heart disease or high or low blood pressure: Effexor may occasionally make these conditions worse.History of mania: The risk of developing mania may be increased while taking Effexor. This is very important for bipolar patients to watch for.Kidney disease or liver disease: Higher blood levels of Effexor may occur, increasing the chance of side effects. Your doctor may need to adjust your dose. How to Take Effexor Effexor XR is taken once each day. Typical doses range from 37.5 mg to 225 mg, with a typical target dose of 75 mg per day. Your healthcare provider will typically start at a lower amount and gradually increase the dose until they determine the right dose for you. The medication should be taken with food at any time of day, morning or night. However, if you have trouble sleeping after taking Effexor, it may be best to take your medication in the morning. Warnings and Interactions Warnings are established to both ensure the safe use and discontinuation of Effexor. Your doctor should monitor you for the following complications while you're taking Effexor. Serotonin Syndrome Be careful when mixing Effexor with other medicines that also affect serotonin levels, such as other antidepressants, lithium, and St. John's wort. Doing so can lead to an excessive serotonin buildup in the brain. This can cause a condition called serotonin syndrome. Symptoms of serotonin syndrome include: ConfusionDiarrheaDilated pupilsFeverLoss of muscle coordinationMuscle stiffnessSudden spikes in blood pressure or heart rateSweating or shiveringTwitching musclesUnusual agitation or restlessness Some cases of serotonin syndrome can be life-threatening. If you're taking Effexor and experience any of these symptoms, contact your doctor as soon as possible. Risk of Overdose You should always avoid drinking or using other drugs while you're taking Effexor. These substances may decrease the benefits of the medication, or they can result in a toxic overdose. The most common Effexor overdose effects include: Changes in consciousness (ranging from sleepiness to coma)Dilated pupilsFast heart rateSeizuresVomiting To reduce your risk of overdose, your doctor will only prescribe you the lowest possible dose in the smallest quantity. How to Tell If Someone Has Overdosed on Antidepressants Suicidal Thoughts and Actions Children and adolescents (up to age 25) may experience increased suicidal thoughts and behaviors when taking antidepressant medications. The danger is greatest the first few months of treatment or when changing the dose. Though this warning is true for all antidepressants, taking Effexor may increase your risk even more. A major study found that Effexor was associated with a higher risk of both completed and attempted suicide compared with other antidepressants, including Celexa (citalopram), Prozac (fluoxetine), and Prothiaden (dothiepin). If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Discontinuation Syndrome Stopping Effexor abruptly may result in one of more of the following withdrawal symptoms: Anxiety or worsening of depression Dizziness Gastrointestinal upset Headaches Irritability Nausea Nightmares Paresthesias (prickling, tingling sensation on the skin) Vomiting It's important not to stop taking Effexor on your own. If you and your doctor decide you should stop Effexor, they can provide you with a tapering strategy to minimize any withdrawal symptoms Tips to Reduce Antidepressant Discontinuation Symptoms A Word From Verywell Before prescribing Effexor, your doctor will take a thorough medical history. Even so, it's important for you to play an active role in your care. Be sure to share every detail of your health history, regardless of whether or not you think it's important. Overall, Effexor is a well-tolerated medication that has helped many people cope with a variety of mental health conditions. You deserve to get well. The good news is that if Effexor doesn't help, there are lots of other options to try. 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Shelton RC. Serotonin and norepinephrine reuptake inhibitors. Handb Exp Pharmacol. 2019;250:145-180. doi:10.1007/164_2018_164 U.S. Food and Drug Administration. Effexor label. National Alliance on Mental Illness. Venlafaxine (Effexor). Wong J, Motulsky A, Abrahamowicz M, Eguale T, Buckeridge DL, Tamblyn R. Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system. BMJ. 2017:j603. doi:10.1136/bmj.j603 Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. The Lancet. 2018;391(10128):1357-1366. doi:10.1016/S0140-6736(17)32802-7 Ye C, Ninneman M, Christian JS, Zhang F, Musselman D. Seizure induced by a therapeutic dose of Venlafaxine ER: A case report. J Psychiatr Pract. 2018;24(2):117-120. doi:10.1097/PRA.0000000000000298 Patel R, Reiss P, Shetty H, et al. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open. 2015;5(12):e008341. doi:10.1136/bmjopen-2015-008341 U.S. Food and Drug Administration. Suicidality in children and adolescents being treated with antidepressant medications. Rubino A, Roskell N, Tennis P, Mines D, Weich S, Andrews E. Risk of suicide during treatment with venlafaxine, citalopram, fluoxetine, and dothiepin: retrospective cohort study. BMJ. 2007;334(7587):242. doi:10.1136/bmj.39041.445104.BE By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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