If you have anxiety or depression, your medical professional may prescribe a drug called Effexor XR.

Effexor XR is used to treat the following conditions in adults:

We explain more about these conditions and how Effexor XR helps treat them in the “What do you take Effexor XR for?” section below.

Effexor XR details

Effexor XR’s classification is a serotonin-norepinephrine reuptake inhibitor (SNRI).

Effexor XR contains an extended-release (ER) form of venlafaxine. “ER” means your body slowly absorbs the drug over time. Effexor XR comes as capsules that you take by mouth.

Effexor XR is a brand-name drug. It’s also available as a generic drug called venlafaxine ER.

The immediate-release form of brand-name Effexor is no longer available. (Immediate release means your body quickly absorbs the drug after you take it.) However, a generic form of immediate-release venlafaxine is currently available.

We cover only Effexor XR in this article. If you’d like to learn about immediate-release venlafaxine, we encourage you to talk with your medical professional or pharmacist.

Most medications, including Effexor XR, may cause side effects that can be serious or mild. To give you an idea of what might occur with Effexor XR, we’ve listed some of the medication’s more common side effects below. It’s important to note that we haven’t included all the potential side effects.

For more complete information about possible side effects of Effexor XR, you can talk with your medical professional or pharmacist. They may also be able to recommend tips on how to help prevent and ease side effects.

Note: Certain factors may affect a medication’s side effects. These factors can include other health conditions you may have, other drugs you may be taking, and your age.

Mild side effects

Some of the mild side effects that Effexor XR may cause are listed below. For information about other mild side effects of the drug, we suggest that you talk with your medical professional or pharmacist. It may also be helpful to refer to the medication guide for Effexor XR.

Mild side effects of Effexor XR that have been reported in studies include the following:

Mild side effects of many drugs tend to lessen in a couple of days or a few weeks. But if you find that the side effects bother you, we encourage you to talk with your medical professional or pharmacist.

* For details about this side effect, you can see “Side effects: A closer look” below.

Serious side effects

Effexor XR may cause serious side effects, but this isn’t common. It’s possible that Effexor XR may cause long-term side effects. But the length of time side effects from Effexor XR last will be different from person to person.

If you do develop serious side effects while taking Effexor XR, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Serious side effects of Effexor XR that have been reported in studies include the following:

* For details about this side effect, you can see “Side effects: A closer look” below.

Effexor XR side effects in the first week

You may have a higher risk for certain side effects during your first week of Effexor XR treatment.

For example, your risk for suicidal thoughts and behaviors* with Effexor XR is highest right after you’ve started taking the drug.

To lessen your risk for side effects from Effexor XR, your medical professional will start by prescribing a low dosage of the drug. They may increase your dosage slowly over time until the symptoms of your condition have eased. For details, you can see the “What’s the dosage of Effexor XR?” section below.

* Effexor XR has a boxed warning for this risk. For details, you can see the “Side effects: A closer look” section right below.

Side effects: A closer look

This section provides a close-up look at key side effects of Effexor XR.

Weight loss or weight gain

Weight loss or weight gain may occur with Effexor XR. Weight changes were more common in children* than in adults during studies of the drug.

It’s important to note that weight changes are common in anxiety and depression, which Effexor XR treats. So you may lose or gain weight while you’re taking Effexor XR because your condition is getting better. This means weight changes may not be a side effect of the drug itself.

* Effexor XR isn’t approved for use in people younger than 18 years of age.

Tips for managing

If you’re concerned about weight loss or weight gain while taking Effexor XR, we encourage you to talk with your medical professional. They can recommend ways to help you manage your weight.

Sexual side effects

Sexual side effects may occur with Effexor XR. These were common side effects in studies of the drug.

Loss of libido (sex drive) was a common side effect in males* and females* taking Effexor XR.

Other sexual side effects in males may include:

Sexual side effects in females may also include not being able to have an orgasm.

It’s important to note that anxiety and depression, which Effexor XR is used to treat, can also cause sexual side effects. It may be difficult to tell whether these side effects are caused by the drug or the condition you’re taking Effexor XR to treat.

* We use the terms “male” and “female” to refer to someone’s sex assigned at birth. For details about the difference between gender and sex, you can see this article.

Tips for managing

If you have sexual side effects while taking Effexor XR, we recommend that you talk with your medical professional. They can help you figure out if the side effects are from Effexor XR or the condition it’s treating.

Allergic reaction

Many drugs, including Effexor XR, can cause an allergic reaction. Although allergic reaction wasn’t reported in studies of Effexor XR, it can still happen.

Symptoms that can occur with a mild allergic reaction may include:

  • itchiness
  • skin rash
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction may also occur, but this is rare. Symptoms of a severe allergic reaction may include swelling of your mouth, tongue, or throat, which may cause trouble breathing. You may also experience swelling under your skin, often in your lips, eyelids, hands, or feet.

Tips for managing

If you have symptoms of an allergic reaction to Effexor XR, be sure to call your medical professional immediately. If you feel as if you’re having a medical emergency, call 911 or your local emergency number right away.

Boxed warning

Effexor XR has a boxed warning from the Food and Drug Administration (FDA) about suicidal thoughts and behaviors in young people. It appears on the drug’s label and alerts you to possible serious risks.

Medications used to treat depression can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. These drugs include Effexor XR. However, Effexor XR isn’t approved for use in people younger than age 18 years.

The risk for this side effect is higher in people who:

  • recently had a dosage change
  • recently started taking the drug
  • are age 24 years or younger*

While you take Effexor XR, it’s recommended that you watch for the following symptoms:

Tips for managing

If you have any unusual changes in behaviors, moods, thoughts, or feelings while taking Effexor XR, it’s important to tell your medical professional right away. They may adjust your treatment plan or prescribe a different drug for your condition.

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.

We describe commonly used dosages of Effexor XR below. But always take the dosage your medical professional recommends.

Form and strengths

Effexor XR comes as capsules that you take by mouth. They’re available in the following strengths: 37.5 milligrams (mg), 75 mg, and 150 mg.

Recommended dosages

Typically, your medical professional will start by prescribing a low dosage of Effexor XR. Then they’ll slowly increase your dosage over time until the symptoms of your condition have eased.

They may prescribe a different dosage depending on certain factors, such as:

  • other medications you take
  • other health conditions you have

If you have questions about the dosage that’s right for you, we recommend that you talk with your medical professional.

Dosage for generalized anxiety disorder. The usual starting dosage of Effexor XR for generalized anxiety disorder (GAD) is 75 mg once per day. The maximum dosage for GAD is 225 mg each day.

Dosage for social anxiety disorder. For social anxiety disorder, the usual starting dosage of Effexor XR is 75 mg once per day. The manufacturer of Effexor XR hasn’t recommended a maximum dosage for this use.

Dosage for major depressive disorder. The usual starting dosage of Effexor XR for major depressive disorder (MDD) is 75 mg once per day. The maximum dosage for MDD is 225 mg each day.

Some people may need to use daily dosages of 300 mg or higher for MDD. Taking dosages this high is considered an off-label use. (Off-label means using a drug in a way it hasn’t been approved to be used.)

Dosage for panic disorder. For panic disorder, the usual starting dosage of Effexor XR is 37.5 mg once per day. The maximum dosage for panic disorder is 225 mg once per day.

Find answers to some commonly asked questions about Effexor XR.

Could I have withdrawal symptoms if I stop taking Effexor XR?

Yes, suddenly stopping Effexor XR treatment can lead to withdrawal symptoms.

Possible symptoms of withdrawal from Effexor XR can include:

Unless your medical professional says it’s safe to do so, don’t stop taking Effexor XR. When it’s time for you to stop using the drug, they’ll help you begin weaning off Effexor XR. They’ll do this by slowly lowering your dosage over time, which helps lessen your risk for withdrawal symptoms.

If you have other questions about Effexor XR and withdrawal, you can talk with your medical professional.

Does how long Effexor XR stays in your system depend on its half-life?

Yes, the half-life of Effexor XR can determine how long the drug stays in your system.

The half-life of Effexor XR is about 5 hours. (The half-life is the amount of time it takes for half of a drug’s dose to leave your system.) So it takes about 5 hours for your body to get rid of half of a dose of Effexor XR.

It usually takes about four to five half-lives for a drug to leave your system entirely. For Effexor XR, this means the drug will stay in your system for about 25 hours.

How do some alternatives to Effexor XR compare with it?

There are several alternatives to Effexor XR for treating anxiety or depression.

Effexor XR belongs to a group of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications work by increasing the levels of brain chemicals called norepinephrine and serotonin. This helps improve your mood and emotions.

Duloxetine (Cymbalta) is an example of another SNRI that may be used to treat anxiety or depression.

Like SNRIs, selective serotonin reuptake inhibitors (SSRIs) are a group of drugs that increase levels of serotonin in the brain. SSRIs are also used to treat anxiety or depression.

Examples of SSRIs that may be used for these conditions include:

In addition, some drugs may be used off-label to treat anxiety or depression. (Off-label means using a drug for a condition it hasn’t been approved to treat.) An example is topiramate (Topamax).

As with SNRIs and SSRIs, Topamax is thought to affect brain chemicals. But the exact way the drug works to treat anxiety and depression isn’t known. Your medical professional can tell you whether using Effexor XR and Topamax together is right for you.

If you have more questions about alternatives to Effexor XR, you can talk with your medical professional or pharmacist. They can recommend the treatment option that’s best for your condition.

Can Effexor XR be used to treat hot flashes or vestibular migraine?

Effexor XR isn’t currently approved to treat hot flashes or vestibular migraine. But the drug may be used off-label for these conditions. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

The term “hot flash” is commonly associated with menopause. It describes moments of sudden, intense feelings of heat that aren’t caused by an external heat source.

Studies have found venlafaxine* to be effective for treating hot flashes related to menopause. However, it’s important to note that feeling hot or flushed is a possible symptom of anxiety. (Effexor XR is approved to treat anxiety.) So if you have hot flashes as a symptom of anxiety, Effexor XR may provide relief for you. But the drug isn’t specifically approved to treat hot flashes.

Vestibular migraine is a type of migraine that causes vertigo (dizziness). Unlike other types of migraine, vestibular migraines don’t typically cause severe headache. A study has found venlafaxine* to be effective for preventing vestibular migraine.

If you have questions about using Effexor XR to treat hot flashes or vestibular migraines, you can talk with your medical professional.

* Venlafaxine is the active ingredient in Effexor XR.

Before taking Effexor XR, it is important to talk with your medical professional. Tell them about your overall health and any medical conditions you have. Also tell them about all other medications you’re taking.

We describe these considerations below in more detail.

Interactions

Taking certain drugs, foods, vaccines, and other substances with a medication may affect how that medication works. These effects are known as interactions.

Before you take Effexor XR, be sure to tell your medical professional about any other drugs you take. This includes prescription and over-the-counter medication. It’s also important to mention any herbs, supplements, and vitamins you may use. They or your pharmacist can tell you about possible interactions these substances may have with Effexor XR.

Interactions with drugs or supplements

Effexor XR can interact with several types of drugs. These drugs include:

It’s important to note that we haven’t listed all types of drugs that may interact with Effexor XR. Your medical professional or pharmacist can provide more details as well as information about other possible interactions.

* Because of this interaction, you should not take Effexor XR with an MAOI.

Other interactions

Effexor XR can cause false-positive results on certain lab tests.

Specifically, Effexor XR can do this on a urine drug screen for amphetamine and phencyclidine (PCP). But it depends on the type of drug test that’s used.

If a false-positive result occurs, a different type of drug test can be done to rule out the use of amphetamine and PCP.

Before taking a drug test, make sure your medical professional knows you’re taking Effexor XR. This will help them correctly interpret your test results.

FDA boxed warning

Effexor XR has a boxed warning from the Food and Drug Administration (FDA) about suicidal thoughts and behaviors in young people. The boxed warning appears on the drug’s label and alerts you to possible serious risks.

Medications used to treat depression can increase the risk ofsuicidal thoughts and behaviors in children, adolescents, and young adults. This includes Effexor XR. It’s important to note that Effexor XR isn’t approved for use in people younger than age 18 years.

For details, you can see “Side effects: A closer look” in the “Does Effexor XR have side effects?” section above.

Other warnings

If you have certain medical conditions or other factors that affect your health, Effexor XR may not be the right choice for you. Before you take Effexor XR, it’s important to discuss your health history with your medical professional. The list below includes some factors to consider.

  • Angle-closure glaucoma. Before starting Effexor XR treatment, telling your doctor if you have angle-closure glaucoma is key. The drug can increase your risk for a glaucoma attack (sudden worsening of glaucoma that leads to eye pain and blurry vision). If you have these symptoms while taking Effexor XR, call 911 or your local emergency number right away.
  • Bipolar disorder. Effexor XR may cause mania or hypomania (moments of extremely high excitement and energy that may be related to bipolar disorder). Before taking Effexor XR, it’s recommended that you tell your medical professional if you have bipolar disorder. They may prescribe a drug other than Effexor XR for you.
  • Diabetes. Before you start taking Effexor XR, it’s important to tell your doctor if you have diabetes. The drug isn’t known to impact blood sugar levels. But other drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs) have been shown to affect blood sugar. (Effexor XR is a type of SNRI.) Your medical professional may monitor your blood sugar levels more closely than usual if you have diabetes and take Effexor XR.
  • High blood pressure. If you have high blood pressure, let your your medical professional know before starting Effexor XR treatment. The drug may increase your blood pressure. So if you already have high blood pressure, you may not be able to take Effexor XR. They’ll typically treat your high blood pressure before you start taking Effexor XR.
  • Kidney or liver problems. If you have kidney or liver problems, your body may have trouble removing Effexor XR from your system. This could cause the drug to build up in your body, which can increase your risk for side effects from Effexor XR. Before you take the medication, telling your medical professional about any kidney or liver problems you have is key. They’ll typically prescribe a dosage of Effexor XR that’s lower than the recommended dosage.
  • Seizures. Effexor XR may cause seizures. If you already experience seizures before taking the drug, you may be at a higher risk for them during your treatment with Effexor XR. Before you take Effexor XR, be sure to tell your medical professional about any seizures you’ve had. They can advise you on whether the medication is right for you.
  • Allergic reaction. If you’ve had an allergic reaction to Effexor XR or any of its ingredients, you should not take Effexor XR. Your medical professional can recommend other treatments that might be better choices for you.

Effexor XR and alcohol

It’s not safe to drink alcohol while taking Effexor XR. Doing so may raise your risk for overdose with the drug. (To learn more, you can see the “Can you overdose on Effexor XR?” section below.)

If you drink alcohol, it’s important to talk with your medical professional before starting Effexor XR treatment. They can suggest ways to help you stop drinking safely. Or they may recommend a drug other than Effexor XR.

Effexor XR use while pregnant or breastfeeding

It may not be safe to take Effexor XR during pregnancy or while breastfeeding.

It’s recommended that you talk with your medical professional about the risks and benefits of taking Effexor XR while you’re pregnant or breastfeeding.

If you have anxiety or depression, your medical professional may prescribe Effexor XR.

Effexor XR is used to treat the following conditions in adults:

  • Generalized anxiety disorder. With generalized anxiety disorder, you have symptoms of anxiety daily for at least 6 months. These symptoms may include:
    • feeling worried or restless
    • trouble breathing
    • trouble concentrating
    • trouble sleeping
  • Social anxiety disorder. With social anxiety disorder (SAD), you have an intense fear of being in a social setting. Symptoms of SAD may include:
    • blushing
    • intense worry about a social situation for days or weeks before the event
    • missing work, school, or another important event because of anxiety
    • rapid heart rate
    • trouble speaking
  • Major depressive disorder. Major depressive disorder (MDD) is commonly referred to as clinical depression. With MDD, you have symptoms of depression almost daily for at least 2 weeks. These symptoms may include:
    • changes in mood
    • loss of interest in activities that were once enjoyable
    • trouble sleeping
    • weight changes
  • Panic disorder with or without agoraphobia. Panic disorder refers to sudden, intense anxiety symptoms that happen without an obvious trigger. Effexor XR is used to treat panic disorder that occurs with or without agoraphobia, which is an intense fear of being in public.

Effexor XR belongs to a group of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). Effexor XR works by increasing the levels of brain chemicals called norepinephrine and serotonin. This helps improve your mood and emotions.

Your medical professional can help explain how to take Effexor XR. They can also advise you on how much to take and how often. It’s important to follow the instructions they provide.

Tips for taking Effexor XR

Effexor XR comes as capsules that you swallow whole. You’ll likely take the capsules once per day with food.

It is important to try to take your dose around the same time each day. This helps keep a steady level of the drug in your system, which can help prevent withdrawal symptoms. (To learn more about withdrawal, you can see the “What are some common questions about Effexor XR?” section above.)

It’s important to avoid driving while taking Effexor XR until you know how the drug affects you.

Effexor XR can make you feel sleepy. It can also affect your ability to react quickly or think clearly. These side effects can be dangerous if they occur while you’re driving.

If you have questions about how to take Effexor XR, you can talk with your medical professional.

Frequently asked questions about taking Effexor XR

Here are some frequently asked questions about Effexor XR treatment:

  • What should I do if I miss a dose of Effexor XR? It’s recommended that you take your missed dose of Effexor XR as soon as you remember. If it’s almost time for your next dose, you can skip the missed dose and take your next dose at your regular time. You should not take an extra dose of Effexor XR to make up for a missed dose. The extra dose may increase your risk for serious side effects from the drug. If you aren’t sure whether to take a dose or skip it, your medical professional or pharmacist can advise you.
  • Is Effexor XR meant for long-term use? Your medical professional may prescribe Effexor XR for long-term use. If the drug is working for you and isn’t causing bothersome side effects, you’ll likely take Effexor XR long term.
  • Can you chew, split, or crush Effexor XR? Effexor XR shouldn’t be chewed or crushed. But if you have trouble swallowing an Effexor XR capsule whole, you can open the capsule and sprinkle its contents onto applesauce. You can then swallow the applesauce and Effexor XR contents without chewing. Drinking a full glass of water after you swallow the applesauce helps make sure you take the full dose. For more details about taking Effexor XR, we encourage you to talk with your medical professional or pharmacist.
  • Should you take Effexor XR with food? Yes, you should take Effexor XR with food.
  • How long does Effexor XR take to work? You may not notice the symptoms of your condition start to ease until you’ve taken Effexor XR for several weeks. To learn what to expect with Effexor XR treatment, we encourage you to talk with your medical professional.
What should you ask your medical professional?

It’s common to have questions about your treatment plan for Effexor XR. Your medical professional is there to work with you and help address any concerns you have.

To help guide your discussion, here are some suggestions:

  • You can write down questions you have before your visit. For example, “How will taking Effexor XR affect my mood, body, and lifestyle?”
  • You can think about asking a loved one or friend to come with you to your appointment. Having in-person support may help you feel more at ease.
  • You can ask your medical professional to explain something that you find unclear.

Working with your healthcare team may help you stay on track with your treatment. If you find that you’re not getting answers to your questions or receiving the care you deserve, consider seeking a second opinion.

Effexor XR is a prescription drug. The costs of prescription medications may depend on several factors, such as your insurance coverage and the pharmacy you use. To find current prices for Effexor XR capsules near you, you can visit GoodRx.com.

If you’re wondering how to pay for Effexor XR, we suggest that you talk with your medical professional or pharmacist. You may also want to visit the website of the Effexor XR manufacturer to see if support options are available.

Studies of Effexor XR have shown a low risk of the drug being misused. (Misuse means taking the drug in a way other than how your medical professional recommended.)

But it’s still possible for Effexor XR to be misused.

Be sure to take Effexor XR exactly as your medical professional recommends you take it. They may monitor you for signs of misuse from time to time during treatment.

It’s important that you don’t take more Effexor XR than your medical professional recommends. Taking more than the recommended dosage can lead to severe side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Effexor XR

If you believe you’ve taken too much Effexor XR, call your medical professional right away. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if your symptoms are severe, immediately call 911 (or your local emergency number) or go to the closest emergency room.

If you still have questions about Effexor XR after reading this article, we recommend that you talk with your medical professional. Together you can decide if Effexor XR might be a good choice for you.

You can also discuss other treatments, forms of support, and resources that may benefit you. We’ve listed some helpful suggestions below.

Additional treatment options

While you take Effexor XR, additional treatments or remedies may help you better manage your condition. These can include:

Finding support

Whether you’re looking for a therapist, support group, or information about how to afford therapy, these resources may help:

Other resources

To receive weekly information about mental health, you may want to sign up for the Psych Central newsletter. You’ll find stories directly from other people about their mental health journey as well as the latest information about treatments.

Disclaimer: Psych Central has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.