*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.
Effexor is commonly prescribed for the treatment of depression, anxiety, and other mental health disorders. Taking the medication may result in side effects which can become severe for certain individuals. If you’re considering Effexor, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Effexor or another medication may help your symptoms.
Boxed Warning: Venlafaxine (Effexor XR) - Risk of suicidal thoughts and behaviors in certain people
Venlafaxine, the active ingredient in Effexor XR, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Venlafaxine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with venlafaxine and any other medications before starting treatment.
What Is Effexor (Venlafaxine)?
Effexor (venlafaxine) is an FDA-approved medication for depression, anxiety, and other mental health conditions.1 Effexor belongs to the serotonin and norepinephrine reuptake inhibitors (SNRIs) class of drugs which regulate serotonin and norepinephrine levels in the brain.
Taking Effexor may induce mild side effects. A doctor may prescribe Effexor based on several factors, such as a person’s age, overall health, and the type of condition being treated.
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Various SNRIs have different chemical makeup, contributing to different side effects and reactions. However, SNRIs work similarly to selective serotonin reuptake inhibitors (SSRIs) in relieving symptoms of depression and anxiety. While SSRIs block the reabsorption of only serotonin, SNRIs block the reuptake of both serotonin and norepinephrine.3,6
In some cases, a doctor may prescribe Effexor off-label for the treatment of certain conditions. Effexor should be taken with caution and only as prescribed by a physician.
Effexor is FDA-approved for the treatment of:1
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Social anxiety disorder
- Panic disorder
Effexor may be prescribed off-label for the treatment of:
“Effexor can be a very helpful medication when patients have tried multiple other medications and are struggling with severe symptoms that are not responding to other therapeutic interventions.’”
Dr. Lori Nation, Kentucky State Medical Director at History of Effexor
In 1997, Effexor XR (Venlafaxine extended release) was approved for use in the United States. Effexor is manufactured by various pharmaceutical companies such as TEVA Pharmaceuticals, ANNORA PHARMA, Amneal Pharmaceutical, and Mylan. The companies produce antidepressants in several products and dosages, including capsules, tablets, and solutions. The medication is regularly monitored by the Food and Drug Administration for safety and efficacy.
Effexor Dosages & Delivery Methods
Effexor doses vary depending on the condition being treated as well as the age of the individual. Based on the severity of one’s symptoms, a prescriber will determine which dose is appropriate. Typically, patients are started on a smaller dose in order to determine the medication’s efficacy in treating their symptoms. The amount may be increased if symptom reduction does not occur.
Typical dosages for Effexor include:4
- Tablets (immediate release): 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg
- Tablets (extended-release): 37.5, 75 mg, 150 mg, 225 mg
- Capsules (extended-release): 37.5 mg, 75 mg, 150 mg
Venlafaxine can be administered via four different methods. This mostly depends on several factors: convenience, efficacy, and safety. A prescriber will determine the best option based on the efficacy of the drug, as well as safety concerns and tolerability of the individual.
Delivery methods for Effexor include:4
- Tablet
- Solution
- Capsule
- Extended-release capsule
Effexor is only available via prescription and should be taken as instructed by a doctor. This ensures that the medication remains effective throughout treatment. Furthermore, it helps to prevent the risk of health problems related to overdose, skipped doses, and abrupt cessation. Effexor is typically administered orally once daily. Contact a prescriber for assistance if you have concerns about your prescription.
Effexor Warnings & Associated Risks
Effexor is associated with mild side effects. However, these may worsen and become severe for those with certain medical conditions or if Effexor is combined with another substance. Adverse reactions can be life-threatening, possibly resulting in overdose, organ failure, and sudden death.7
It is important to disclose one’s current and past histories of health conditions with a doctor while considering Effexor. Doing so ensures that an individual’s safety is maintained while receiving treatment. Taking Effexor with certain medical conditions can be life-threatening. Additionally, children and young adults are at increased risk of suicidal thoughts and behaviors when taking the medication.
Effexor may not be suitable for those who have a history of or are currently:1
- Bipolar disorder: Patients should be screened for bipolar disorder, as Effexor can trigger manic episodes.
- Seizures: Patients with a history of seizures are at increased risk of experiencing episodic seizures.
- Pregnant: Taking Effexor while pregnant increases the risk of birth defects.
- Breastfeeding: Effexor can contaminate breast milk and increases the risk of infant exposure to the medication.
- Bleeding problems: Effexor can affect the body’s blood clotting process, increasing the risk of excessive bleeding.
- Glaucoma: Effexor can cause pupil dilation and contraction of muscles in the eye, increasing the risk of angle-closure glaucoma and vision problems.
- Low salt levels: Taking Effexor can lead to serotonin and norepinephrine imbalance and increase the risk of hyponatremia.
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Side Effects of Effexor
Taking Effexor may result in side effects within the first or second week of treatment. Common Effexor side effects include nausea and vomiting. Sexual side effects from Effexor may also occur for some people.
Side effects of Effexor can be severe and require immediate medical attention. The severity of one’s reaction to the medication depends on various factors such as the individual’s age and current health conditions. Additionally, abruptly stopping or mixing other substances with Effexor can worsen side effects. If left untreated, severe reactions can result in death. It’s important to discuss these risks with a doctor before taking Effexor.
Common side effects of Effexor include:1
- Drowsiness
- Dizziness
- Dry mouth
- Diarrhea or constipation
- Headache
- Sweating
- Nervousness
- Indigestion
- Sexual problems
- Appetite issues
- Sleeping problems
- Weight changes
Severe side effects of Effexor that require immediate attention include:1
- Seizures: Effexor increases the risk of experiencing episodic seizures.
- Serotonin syndrome: Taking Effexor long-term can lead to serotonin buildup in the body, resulting in serotonin syndrome.
- Manic episodes: Individuals with bipolar disorders are likely to experience manic episodes when on Effexor.
- Excessive bleeding: Effexor can interfere with the blood clotting process, increasing the risk of excessive bleeding.
- Vision problems: Effexor can lead to pupil dilation and muscle contraction in the eye, resulting in angle-closure glaucoma.
- Anxiety symptoms: Taking Effexor long-term may decrease its efficacy, resulting in re-emerging or worsening symptoms of anxiety.
- Discontinuation syndrome: Stopping Effexor without proper guidance from a prescriber increases the risk of Effexor withdrawal. Dr. Lori Nation adds, “Sometimes when patients start to feel better, they decide they no longer need their medication and stop it abruptly. This can elicit a disturbing withdrawal cascade that can turn the patient off from medication long term.”
Allergic Reactions to Effexor
Inform your doctor if you have a history of allergic reactions to other antidepressants. Severe allergic reactions to Effexor can be dangerous, especially if you experience difficulty breathing.
Symptoms of an allergic reaction to Effexor may include:
- Swelling
- Rash
- Hives
- Breathing difficulties
Interactions With Effexor
Taking certain medications, herbs, or supplements alongside Effexor can change how Effexor works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Effexor can have harmful interactions with other substances, dietary supplements, or medications, especially if you combine the two substances. Skipping or stopping Effexor in order to consume another substance can still result in an interaction. Because of this, it is important to refrain from mixing Effexor with another substance and inform your doctor of any supplements or remedies you are considering or currently taking.
Substances that negatively interact with Effexor include:1
- NSAIDs: Combining Effexor with NSAID drugs increases the risk of excessive bleeding.
- MAOIs: Taking Effexor within 14 days of stopping MAOI treatment increases the risk of serotonin syndrome.
- Alcohol: The interaction between alcohol and Effexor can trigger or worsen the effects of either substance.
- Other SNRIs: Mixing other SNRIs with Effexor puts increases the risk of worsening anxiety or depression symptoms.
- Pimozide: Combining Effexor with pimozide increases the risk of serotonin syndrome.
- Benzodiazepines: Taking benzodiazepines while on Effexor can worsen side effects.
- SSRIs: Taking other SSRIs, such as Citalopram (Celexa), can worsen anxiety by triggering side effects.
- Blood thinners: The interaction between Effexor and blood thinners increases the risk of excessive bleeding.
- Thioridazine: The interaction between Effexor and thioridazine puts increases the risk of serotonin syndrome.
- St. John’s Wort: St. John’s Wort can result in adverse side effects when mixed with Effexor.5
What to Do If You Overdose
Effexor overdose can be severe and result in sudden death. If you are experiencing symptoms of an overdose, call 9-1-1 or visit the nearest emergency room immediately. You can also contact the poison control center at 1-800-222-1222 for further assistance.4
Symptoms of an Effexor overdose include:
- Drowsiness
- Rapid breathing
- Increased heartbeat
- Confusion
- Hallucinations
What If I Miss a Dose of Effexor?
Effexor should be taken as prescribed. If a dose is skipped or missed, a person should return to their typical medication routine as usual. If they are interested in seeking an alternative, their doctor can help them find a more suitable medication. They should not stop their prescription abruptly, as this can result in discontinuation syndrome, which is accompanied by severe side effects.2 A doctor can help a person taper off their medication in order to prevent withdrawal symptoms.
Questions to Ask Your Health Team
Before starting Effexor, it is important to understand all of the associated risks of the medication. A physician will review your medical history for possible safety concerns to determine if it is a suitable option for you. If you are concerned about side effects, be sure to ask appropriate questions and stay educated throughout treatment.
Questions to ask your care team about Effexor include:
- Is it safe to take Effexor with my other medications?
- Will my insurance cover Effexor or venlafaxine?
- Does my medical history increase my risk of experiencing side effects?
- How long can I expect side effects to last?
- What side effects should I seek immediate medical attention for?
- How often should I see you for checkups while taking Effexor?
- Should I let my therapist know I am taking this medication?
- What should I do if I want to stop taking Effexor?
- How will I know if I have overdosed on Effexor?
- Can I consume alcohol while on Effexor?
Final Thoughts
Effexor can be an effective part of treatment for depression, anxiety, and other disorders. Taking the medication may result in side effects, and it should therefore only be administered as prescribed. Effexor can negatively interact with other medications or substances, possibly resulting in overdose and sudden death. When considering Effexor, discuss both its benefits and risks with your doctor.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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