*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 XR can cause sexual side effects, including decreased sexual desire in both men and women, delayed or no orgasm in women, and delayed ejaculation in men. If you experience Effexor XR sexual side effects, your healthcare provider may recommend a change in dosage, timing for taking the medication, or to another medication. Additional coping strategies, such as talking to your partner and therapy, can help you cope with these side effects.
If you are considering Effexor XR or want to discuss your current medication treatment with a provider, online psychiatry platforms, such as Talkiatry and Brightside Health are a good place to start. Their providers offer assessments and prescription consultation, and can answer any questions you have about Effexor XR sexual side effects.
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.
Key Takeaways
Effexor XR can cause sexual side effects for both men and women. Some effects may fade after the body adjusts to the medication, but others may persist for as long as a person takes the medication.
Your provider may offer several recommendations for managing sexual side effects from Effexor XR. These may include a dosage adjustment or switching to a different medication. Do not make changes with your medication or stop taking it without specific guidance from your provider.
There are several ways to cope with Effexor XR side effects, including self care and behavioral strategies, medication adjustments, and therapy.
If you are considering an alternative to Effexor XR, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry, or Circle Medical.
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Effexor XR Sexual Side Effects
Effexor XR sexual side effects are common in both men and women and may emerge at any time while taking the medication. While not common, some may experience long-term effects after stopping serotonin norepinephrine reuptake inhibitors (SNRIs) such as Effexor XR. This condition is called post-SSRI sexual dysfunction, however, SNRIs can have long-term impact on sexual functioning as well.1, 2
Because sexual side effects of antidepressants are often underreported, it’s important to speak to your provider about any changes in your sexual functioning after starting Effexor XR.3 Your provider can offer strategies for avoiding or reducing these effects early in your treatment.
The actual risk of sexual side effects of Effexor and other SNRIs is not clear. However, these effects are reported about as frequently with Effexor XR as they are with selective serotonin reuptake inhibitors (SNRIs).4
Venlafaxine Sexual Side Effects in Females
Being female increases the risk of sexual side effects from venlafaxine. The most common of these effects impacting women include:*1
- Delayed or no orgasm
- Decreased desire for sex
- Vaginal dryness
- Discomfort during sexual intercourse
Venlafaxine Sexual Side Effects in Males
Some men taking venlafaxine may also experience sexual side effects. The most common effects impacting men include:*5
- Decreased sex drive
- Inability to get or keep an erection
- Delayed ejaculation
*The use of terms females, males, women, or men are used to describe the sex assigned at birth. Talk with your healthcare provider if you are a different gender than your sex assigned at birth to understand what you can expect from using any medicine.
Why Does Effexor XR Cause Sexual Side Effects?
Effexor XR increases the level of serotonin in the body, which may also affect the activity of other hormones such as testosterone and dopamine. While this process is not completely understood, these hormonal effects may inhibit sex drive for some who take antidepressants such as Effexor XR.6
How Soon Will I Start Feeling Effexor XR Side Effects?
Side effects from SNRIs such as Effexor XR can emerge during the first week or two of taking the medication, with some people feeling side effects as early as within the first few days.7 Drowsiness, nausea, and loss of sexual interest are common right away.
How Long Do Sexual Side Effects Last With Effexor XR?
Sexual side effects can develop soon after starting Effexor XR. These effects may fade after the first several weeks, but some may experience sexual dysfunction for as long as they take Effexor XR.
What If My Side Effects Persist?
If your side effects continue and they are impacting your overall quality of life, speak with your doctor. They may help you consider a change in dosage, timing of dosage, medication, or possibly adding another medication.
Should I Stop Taking Effexor XR If I Have Sexual Side Effects?
Do not stop taking Effexor XR unless you have been advised to do so by your provider. Doing so can lead to antidepressant discontinuation syndrome, also known as antidepressant withdrawal. This can cause uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea.
If you are experiencing sexual side effects from your medication, tell your provider. They will provide a plan for stopping your medication gradually, which can minimize your risk of developing these symptoms.
Can You Reduce Sexual Side Effects of Effexor XR?
Depending on your personal experience, it may be possible to reduce or eliminate sexual side effects caused by Effexor XR. Take note of how your sexual health has changed since starting Effexor XR and speak to your prescriber about your options.
Here are possible recommendations for reducing the sexual side effects of Effexor XR:
Wait for Side Effects to Improve
Side effects may occur for anyone taking medication, and some initial side effects may be due to your body adjusting to the medication. These initial side effects may go away after the first several weeks or they may persist for as long as a person takes the medication.
A healthcare provider may advise you to wait for a few weeks before making medication adjustments to see if sexual side effects improve. Worsened sexual dysfunction is also associated with worsened depression symptoms, so communicating with your provider about these issues is essential for getting the best medication choice for you.8
Make a Dosage Adjustment
Antidepressants like Effexor XR can affect your sex drive at any dose. If you are experiencing sexual side effects from taking Effexor XR, talk to your doctor about whether a lower dose would be right for you. A lower Effexor dose may potentially decrease the impact of the antidepressant on sexual functioning. Do not adjust your dose on your own. Your healthcare provider will give you guidance to help you avoid Effexor withdrawal symptoms or other complications.
Your prescriber may also consider changing your medication to one that requires only a once-a-day dose. Scheduling sexual activity before taking that dose may reduce the risk or impact of sexual side effects.
Consider Switching Antidepressants
If sexual side effects of Effexor XR are not tolerable, you may consider switching to an antidepressant with fewer sexual side effects. Most antidepressants have a risk of sexual side effects, but some have lower risk than others.
Before recommending a different antidepressant, your provider will account for many factors, including your condition, health history, and the specific sexual side effects you’re experiencing. They will also recommend a plan for transitioning from one medication to another. This can help you avoid uncomfortable symptoms that may occur when stopping antidepressants.
Antidepressants with the least reported sexual side effects include:*
- Bupropion (Wellbutrin XL, Wellbutrin SR): Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI) that may affect levels of norepinephrine and dopamine in the brain. Side effects may include insomnia, dry mouth, tremor, and seizures.
- Mirtazapine (Remeron): Mirtazapine (Remeron) is an atypical antidepressant that may enhance the effects of norepinephrine and serotonin in the brain. Side effects may include drowsiness, weight gain, and increased appetite.
- Vilazodone (Viibryd): Vilazodone (Viibryd) is an atypical antidepressant that works by impacting how serotonin affects the brain. Side effects may include nausea, diarrhea, and headache.
- Vortioxetine (Trintellix): Trintellex is a serotonin modulator and stimulator (SMS) that works by affecting various serotonin receptors in the brain. Side effects may include nausea, vomiting, and abnormal bleeding.
*These medications have a black box warning, the most serious kind of warning from the FDA for the risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.
When Should I Call My Doctor About Effexor XR Sexual Side Effects?
Side effects are one of the most common reasons people choose to stop taking medication. While some effects can be managed and may fade away, some do not go away unless a person stops taking the medication. Side effects can occur even if you are taking your medication correctly.
Contact your provider as soon as possible if side effects persist or become hard to tolerate so you can consider other treatment options.
How to Cope With Sexual Side Effects of Effexor XR
Effexor XR sexual side effects may only last a few weeks for some, but they can feel disruptive to a person’s typical sexual activity. It is also possible for these side effects to be long-term. If you notice changes in your sexual functioning while taking Effexor XR, contact your healthcare provider for guidance.
Here are ways to cope with sexual side effects of Effexor XR:
Talk to Your Partner
Talking to your partner can help you better understand the sexual side effects that may occur and how they may affect your relationship. Consider meeting with your provider together to ask questions and learn what your options are if sexual side effects become a problem.
Adjust Routines & Expectations
Changing your sexual routines and adjusting your expectations for sexual activity may help. Plan your sexual activity at times of the day when sexual side effects are less bothersome. You may also find that these changes break you and your partner out of your typical patterns, which may help raise interest in sexual activity.
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Get Good Sleep
Fatigue and sleep deprivation can contribute to a loss of libido. Insomnia may increase the risk for sexual dysfunction, and a lack of sleep or having disrupted sleep patterns has been linked to having a higher risk of erectile dysfunction.9 To maintain better sleep, keep a relaxing schedule in the evenings, limit phone time before bed, set the temperature comfortably, and limit disruptions.
Exercise Regularly
A small number of studies show that moderate exercise may help with sexual dysfunction in women taking antidepressants.10, 11 Exercise done immediately before sexual activity or arousal was most effective, improving sexual functioning, desire, and satisfaction.
Focus on Being Sensual
Sensual sex includes focusing more on pleasure than on performance. It encourages partners to slow down and take the time to connect more intimately.
Also consider non-penetrative sex, or outercourse. Take time to cuddle on the couch or in the bed, hold hands, or massage each other’s shoulders–even when sex isn’t the main goal. These physical connections throughout the day or the week can keep you emotionally and physically connected.
Keep a Consistent Daily Schedule
Following a consistent daily or weekly schedule can keep life more predictable and reduce stress as you adjust to the medication. Also, be sure you are taking your medication as prescribed and at the same time each day. Doing so can limit uncomfortable effects from adjusting to the medication, which may also affect your interest in sex.
Consider Therapy
Psychotherapy can support you and your partner by addressing the impact of sexual dysfunction and helping you develop strategies to manage the side effects. Sex therapy may also be helpful for addressing sexual side effects of Effexor XR. For in-person treatment, your primary care provider or insurance company can provide a referral, or you may get one from family or friends.
To find an online therapist, an online therapist directory is a great starting point. Many online psychiatry platforms, such as Talkiatry and Brightside Health, also offer therapy services.
When to Seek an Alternative to Effexor XR Due to Side Effects
Initial side effects of Effexor XR typically subside after a few weeks. If after some time you are looking to change your medication due to continued side effects, work with a doctor to find an alternative. There are many Effexor XR alternatives available. All classes of antidepressants can help reduce depression symptoms, though potential risks and benefits can vary.
Other SNRIs and selective serotonin reuptake inhibitors (SSRIs) are usually the first antidepressants considered as Effexor XR alternatives because of their safety and effectiveness.
Atypical antidepressants work differently to improve symptoms and don’t fit into a formal category.
Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are older medications with more side effects. However, they may be helpful for those who need to avoid or can’t tolerate other types of antidepressants.
How to Get a Prescription for Effexor XR or an Alternative
If you are looking to start Effexor XR, or are considering an alternative due to side effects, start by speaking with a prescriber. To get a prescription for an Effexor XR alternative in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription Effexor XR alternatives should be included in your treatment plan.
To get an online prescription for Effexor XR or an alternative, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants and some anti-anxiety medications.
Also, Talkiatry can and will prescribe benzodiazepines, which are controlled substances that are sometimes used to treat anxiety symptoms. Your provider may offer a prescription if they feel it may be a good fit for your symptoms.
Questions to Ask Your Provider
Your prescriber will share important information about your Effexor XR prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about sexual side effects from Effexor XR. Follow these tips for safe and effective use of Effexor XR.
Questions to ask your care team about the sexual side effects of Effexor XR include:
- Does venlafaxine cause erectile dysfunction?
- After how long after starting Effexor XR can sexual side effects start?
- What is the best dosage to get fewer sexual side effects?
- When should I contact you if I am experiencing sexual side effects?
- Does Effexor XR lower libido?
- How does Effexor XR impact orgasms?
- What other side effects should I look out for once I start my Effexor XR dose?
Prescriber’s Tips
Your prescriber will share important information about your Effexor XR prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about sexual side effects. Follow these tips for safe and effective use of Effexor XR.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to. Keeping a consistent dosing schedule reduces the chance of unwanted side effects, including sexual side effects. When taking antidepressants, this approach can prevent withdrawal symptoms such as dizziness, brain zaps, and flu-like symptoms.1
- Limit alcohol while taking Effexor and eat a balanced diet to minimize sexual dysfunction and ensure your body can experience and enjoy sex. This is because drinking alcohol can make it hard for your brain to send and receive signals to feel different parts of your body during sex. It can also make it harder for men and women to reach orgasm when having sex. Your healthcare provider can help to determine what is a safe amount of alcohol for you to drink and the best-balanced diet for you.
- Take your medication at the same time each day. Doing so can help you remember to take it, making it as effective as possible. Your healthcare provider can help determine the optimal timing based on your sleep patterns and initial medication response.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Antidepressants have a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- Some antidepressants and anti-anxiety medications can cause drowsiness and may affect your decision making. Talk to your doctor about how taking one of these medications may affect your ability to drive, operate heavy machinery, or do other dangerous activities safely.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications. This is because they are processed by the same gut enzymes, cytochrome P450 (CYPs). These interactions can lead to unwanted side effects or reduce the effectiveness of your prescription medication.12
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Frequently Asked Questions
What Is Effexor XR (Venlafaxine) & How Is It Used?
Effexor (venlafaxine) is an FDA-approved treatment for major depression and generalized anxiety disorder in adults and children. It belongs to the serotonin norepinephrine reuptake inhibitor (SNRIs) drug class, which affects the level of serotonin in the body.1
Does Effexor XR Affect Libido?
It’s possible that hormonal effects of Effexor XR may affect libido. Increased serotonin levels impact hormones such as testosterone and dopamine. While this process is not completely understood, these hormonal effects may inhibit sex drive for some who take Effexor XR.6
Does Effexor XR Cause Erectile Dysfunction?
Yes, Effexor XR can cause erectile dysfunction for some men who take it, meaning that they may have difficulty achieving and maintaining an erection.1
How Common Is Long-term Sexual Dysfunction From Taking Effexor XR?
Sexual side effects from taking Effexor XR are likely common for men and women. These effects are often underreported, with studies reporting a wide range of occurrences.
Can You Take Viagra With Effexor XR?
Yes, it’s possible. If you’re experiencing erectile dysfunction, talk with your doctor about whether taking a medication like Viagra may be helpful for you.
Which Antidepressants Cause the Fewest Sexual Side Effects?
Antidepressants with the fewest reported sexual side effects include bupropion (Wellbutrin XL and SR), mirtazapine (Remeron), vilazodone (Viibryd), and vortioxetine (Trintellix).
Which Antidepressants Cause the Most Sexual Side Effects?
Antidepressants that increase serotonin levels include SSRIs and SNRIs, which tend to cause more sexual side effects than other antidepressants.13
Should I Stop Taking Effexor XR If I Experience Sexual Side Effects?
Do not stop taking Effexor XR unless you have been advised to do so by your provider. Doing so can lead to uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea.
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Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Effexor XR- venlafaxine hydrochloride capsule, extended release. (August 15, 2023). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Healy D. (2019). Post-SSRI sexual dysfunction & other enduring sexual dysfunctions. Epidemiology and psychiatric sciences, 29, e55. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8061302/
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Carvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016). The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. Psychotherapy and psychosomatics, 85(5), 270–288. Retrieved from https://stisa.org.za/wp-content/uploads/2015/05/2016-Carvalho-et-al-Risks-of-side-effects-of-new-antidepressants.pdf
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Lee, K. U., Lee, Y. M., Nam, J. M., Lee, H. K., Kweon, Y. S., Lee, C. T., & Jun, T. Y. (2010). Antidepressant-Induced Sexual Dysfunction among Newer Antidepressants in a Naturalistic Setting. Psychiatry investigation, 7(1), 55–59. Retrieved from https://doi.org/10.4306/pi.2010.7.1.55
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MedlinePlus. (2022, January 15). Venlafaxine. Retrieved from https://medlineplus.gov/druginfo/meds/a694020.html
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Jing, E., & Straw-Wilson, K. (2016). Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. The Mental Health Clinician, 6(4), 191–196. Retrieved from https://doi.org/10.9740/mhc.2016.07.191
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Warden, D., Trivedi, M. H., Wisniewski, S. R., Kurian, B., Zisook, S., Kornstein, S. G., Friedman, E. S., Miyahara, S., Leuchter, A. F., Fava, M., & Rush, A. J. (2010). Early adverse events and attrition in selective serotonin reuptake inhibitor treatment: a suicide assessment methodology study report. Journal of clinical psychopharmacology, 30(3), 259–266. Retrieved from https://doi.org/10.1097/JCP.0b013e3181dbfd04
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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary Changes: Condensed “What is Effexor XR (Venlafaxine) & How Is It Used?” and moved to FAQs. Added sections “How Soon Will I Start Feeling Effexor XR Side Effects?”, How Long Do Sexual Side Effects Last With Effexor XR?”, “What If My Side Effects Persist?” “Should I Stop Taking Effexor XR If I Have Sexual Side Effects?”. Retitled “How to Cope With Sexual Side Effects of Effexor XR” to “Can You Reduce Sexual Side Effects of Effexor XR?”. Retitled section “What Causes Effexor XR Sexual Side Effects?” to ” Why Does Effexor XR Cause Sexual Side Effects”. Added new sections “Talk to Your Partner”, “Adjust Routines and Expectations”, “Get Good Sleep”, “Exercise Regularly”, “Focus on Being Sensual”, “Keep a Consistent Daily Schedule”, “Consider Therapy”. “When to Seek an Alternative to Effexor XR Due to Side Effects”, “How to Get a Prescription for Effexor XR or an Alternative”. Retitled sections “Questions to Ask Your Health Team” to “Questions to Ask Your Provider”, and “Lower Your Dose” to “Make a Dosage Adjustment”. Retitled and expanded “In My Experience” section to “Prescriber’s Tips”. Removed “For Further Reading”, “Be Patient With Your Prescription”. Added FAQs.
Author: Diana Rangaves, PharmD, RPh
Reviewer: Heidi Moawad, MD
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