Effexor (Venlafaxine) Dosage Guide: Uses, Dosages, & How to Take

What Is Effexor (Venlafaxine) & How Is it Used?

Effexor (venlafaxine) has FDA approval for treating depression, anxiety, and other mental health issues. Effexor is a member of the group of medications known as serotonin and norepinephrine reuptake inhibitors (SNRIs), which control the levels of serotonin and norepinephrine in the brain.¹

During the first or second week of treatment, taking Effexor may cause side effects. They take place as the body adjusts to the drug’s presence. The most frequent side effects of Effexor are nausea and vomiting. The use of Effexor XR in those under the age of 18 is not permitted.

Effexor is FDA-approved for the treatment of:

• Major depressive disorder (MDD)
• Generalized anxiety disorder (GAD)
• Social anxiety disorder
• Panic disorder

Effexor may be prescribed as a non-FDA-approved (off-label) treatment for:

• Attention-deficit/hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• Premenstrual dysphoric disorder (PMDD)
• Post-traumatic stress disorder (PTSD)
• Complex pain syndromes
• Hot flashes
• Preventing migraines
• Fibromyalgia
• Pain of diabetic neuropathy

*An off-label treatment is when a medication is used to treat a condition that is not FDA-approved. Doctors may prescribe a medication off-label because they believe there is a benefit to using the medication for a specific condition.

Effexor Formulations

There are four distinct ways that the patient can take venlafaxine. Several factors, including efficacy, safety, and convenience, primarily determine this. A physician will choose the course of treatment that is most appropriate for their patient based on the drug’s effectiveness, any safety concerns, and how well they tolerate the medication.

Effexor can be delivered in a variety of ways, including:

• Tablet
• Solution
• Capsule
• Extended-release capsule

Take the extended-release capsule, tablet, solution, or capsule with food at roughly the same time each day, either in the morning or the evening. The pill should not be divided, chewed, crushed, or submerged in liquid unless directed otherwise by the doctor. If your doctor or pharmacist instructs you to take the medication a certain way, follow them precisely. To benefit from this medication for your illness, only take it as your doctor prescribes.

Effexor Forms and Strengths

Effexor comes in different forms and strengths.² Your doctor will choose the Effexor dosage based on several variables. Among them are the kind and severity of the ailment you are treating with Effexor and any additional medical issues you might have. They typically start you on a low dose and gradually increase it to minimize the chance of adverse side effects. The usual Effexor dosage is 37.5 mg daily at first, rising to 75 mg after a week. Your doctor could advise you to raise your dose every few days.

Effexor Dosages for FDA-Approved Treatment

The Food and Drug Administration (FDA) of the US Government reviews and approves medications as treatments for many health conditions. This means that the benefits of a medication outweigh the potential risks. The dosages for Effexor, an FDA-approved medication, vary by the disorder and the individuals taking them.

Effexor Dosage for Major Depressive Disorder (MDD)

Effexor belongs to a subclass of antidepressants known as selective serotonin reuptake inhibitors (SNRI). The levels of serotonin and norepinephrine in the brain are regulated as a result of this activity.³ One of the neurotransmitters in your body that affects the control of how your body reacts to stress is called norepinephrine.

The Food and Drug Administration (FDA) has approved Effexor to treat major depressive disorder (MDD). Although you should start to feel better after 1–2 weeks, venlafaxine often takes 4–6 weeks to take full effect. To gain the most benefit in depression treatment, take the medication consistently each day. The best time to take it is in the morning if you have difficulties falling asleep.

Effexor immediate-release oral tablets dosages for depression include:

• Typical starting dosage: Venlafaxine dosage starts at, 75 mg/day PO divided q8–12 hours. For geriatric patients, initially, 25–50 mg/day, divided into q8–12 hours.
• Dosage increases: 75 mg/day may be raised, but not more frequently than every four days. For geriatric patients, 25 mg/day may be added as tolerated, but not more frequently than every four days.
• Maximum dosage: Maximum dose of venlafaxine should be up to 375 mg/day, distributed as q8–12 hours.

Effexor extended-release oral tablets dosages for depression include:

• Typical starting dosage: Venlafaxine dose ranges between 37.5-75 mg PO once daily.
• Dosage increases: Dosages may be increased up to 75 mg/day every four days.
• Maximum dosage: Dosages are no more than 225 mg per day.

Effexor Dosage for Generalized Anxiety Disorder (GAD)

The FDA has authorized several antidepressants, including Effexor, for anxiety treatment for conditions such as generalized anxiety disorder (GAD). ⁴ It can help regulate emotions, tense muscles, and cognitive dysfunction brought on by extreme anxiety. Before you notice a noticeable difference in your anxiety symptoms after starting Effexor, it might take a few weeks. Effexor extended-release oral tablets dosages for GAD include:

• Typical starting dosage: Initial dosages are 37.5-75 mg PO once daily.
• Dosage increases: 75 mg/day can be increased every four to seven days. The dosage may be raised by 37.5 mg every four days for geriatric patients.
• Maximum dosage: Dosages are not more than 225 mg per day.

Effexor Dosage for Social Anxiety Disorder

Effexor is an FDA-approved medication for social anxiety treatment. The extended-release (XR) version of the antidepressant venlafaxine decreases the fear, anxiety, and associated symptoms in people with a social anxiety disorder (SAD), also known as social phobia, after four or six weeks of treatment.⁵ Effexor extended-release oral tablets dosages for social anxiety disorder include:

• Typical starting dosage: In the beginning, 37.5-75 mg per day in one dose in the morning or evening.
• Dosage increases: Your doctor may change your dose if necessary and tolerated. The dosage may be raised by 37.5 mg every four days for geriatric patients.
• Maximum dosage: Dosages are not over 225 mg each day.

Effexor Dosage for Panic Disorder (PD)

The FDA has approved Effexor for panic disorder treatment in adults. Within the first two weeks of taking Effexor, you might notice some of your symptoms improving. For Effexor to work for panic disorder, it could take six to eight weeks or longer. Effexor extended-release oral tablets dosages for panic disorder include:

• Typical starting dosage: Initial dosage is 37.5 mg PO once daily for seven days, followed by 75 mg once daily.
• Dosage increases: 75 mg/day may be added to the dosage every week and possibly increased by 37.5 mg/day every seven days for geriatric patients.
• Maximum dosage: Dosages are not more than 225 mg per day. 

Effexor Dosage for Non-FDA-Approved (Off-Label) Uses

In medicine, off-label for an indication that is not FDA-approved is a common practice. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Using venlafaxine off-label is allowed for conditions including premenstrual dysphoric disorder, fibromyalgia, diabetic neuropathy, complex pain syndromes, hot flashes, and migraine prevention.

Possible  non-FDA-approved (off-label) uses for Effexor may include:

• Attention-deficit hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• PTSD
• Neuropathic pain
• PMDD

If you are interested in using Effexor for off-label use, you should talk with your healthcare professional. They can help to determine if it is safe for you to use Effexor and what dose you should take.

Effexor Dosing Considerations

Make sure your doctor is aware of all of your past medical conditions. When considering Effexor, discussing any current or prior medical conditions with a doctor is crucial to remain as safe as possible during treatment.

Conditions that require special Effexor dosing considerations include:

• Bipolar disorder: Given that Effexor can cause manic episodes, patients should be evaluated for bipolar disorder.
• Kidney problems: The likelihood of side effects may increase due to higher blood levels of Effexor. Your dose might need to be changed by your doctor.
• Heart condition: Sometimes, Effexor may aggravate heart conditions.
• Epilepsy: When taking Effexor, there may be an increased risk of seizures.
• Pregnancy: There is a risk of harm to the baby when Effexor is taken during pregnancy.
• Problems with bleeding: Effexor may interfere with how the body clots blood, which could lead to excessive bleeding.

What to Do If You Overdose on Effexor

An extreme overdose of Effexor may cause premature death.⁶ Call 9-1-1 or go to the closest emergency room immediately if you show signs of an overdose. For more assistance, you can also call the poison control center at 1-800-222-1222.

Symptoms of minor overdoses or small dosage errors can include tachycardia, mild changes in blood pressure, nausea, vomiting, anorexia, drowsiness, and a slight tremor. Large overdoses can cause coma, delirium, seizures, and changes in mental status. The traditional definition of addiction does not apply to Effexor. Although not commonly abused, some claim that abusing the drug can result in high resembling amphetamine; this claim has not been adequately researched.

What if I Miss a Dose of Effexor?

For safety, you should take Effexor as directed. The patient should resume their regular medication schedule if a dose is missed or skipped. Their doctor can assist them in locating a more suitable medication if they are interested in an alternative. They should not stop taking their prescription suddenly because doing so can cause antidepressant discontinuation syndrome, which has serious side effects. To avoid withdrawal symptoms, a patient can taper off their medication with the assistance of a doctor.

Before you notice any benefits of treatment, it may take 1 to 2 weeks. However, feeling the full effects typically takes 4 to 6 weeks. This is because it takes about a week for venlafaxine levels to increase in your body, and it takes your body an additional few weeks to adjust and become accustomed to it. Even if you start to feel better, do not stop taking venlafaxine. After hearing from you, your doctor will determine how long you need to take the medication. Venlafaxine missed doses may increase the likelihood of symptom relapse.

Questions to Ask Your Health Team

Understanding all of the potential side effects of Effexor is crucial before taking it. Before giving you a prescription, a doctor will review your medical history for any potential safety issues. If you are worried about side effects, stay informed throughout treatment and ask the right questions. In case of emergencies, call 9-1-1 or the poison control center at 1-800-222-1222.

• Questions to ask your care team about Effexor dosages include:
• Is it safe to take Effexor with my other medications?
• Will Effexor or Venlafaxine be covered by my insurance?
• Does my medical history indicate a need to adjust my dosage?
• How long will it take before my symptoms improve?
• Should I let my therapist know I am taking this medication?
• What should I do if I want to stop taking Effexor?

In My Experience

In my experience, actively participating in your care is essential. Disclosing every aspect of your medical history is important for your safety and treatment outcome, even if you don’t think doing so is necessary or that matters. For treating depression, anxiety, and other disorders, Effexor may be a valuable component. The medication should only be taken as directed because doing otherwise could cause adverse effects. Harmful interactions between Effexor and other drugs or substances increase the risk of overdose and premature death. With your doctor, go over the advantages and disadvantages of Effexor.

For Further Reading

• Effexor (Venlafaxine) Side Effects: Common, Severe, & Rare
• Effexor (Venlafaxine) For Anxiety: Effectiveness, Dosage, & More
• How to Get an Effexor (Venlafaxine) Prescription
• Everything to Know About Effexor Withdrawal
• Effexor Weight Gain: Everything You Need to Know
• Medication for Depression: Types, Side Effects, & Management.
• Psychotherapy vs Medication for Depression and Anxiety