Effexor is a prescription drug in a class known as selective serotonin or norepinephrine reuptake inhibitors. These drugs help to regulate the amount of serotonin or norepinephrine in the brain to help maintain a more stable mental balance. These drugs are not capable of curing depression, but they can help make the symptoms more manageable. It may take up to 6-8 weeks for this medication to take an effect on your symptoms, so do not be disheartened if you do not see results initially.
Indications and Usage
Effexor and Effexor XR are the brand names for the drug venlafaxine, which is used to treat depression, generalized anxiety, social anxiety disorder, and panic disorder. In some cases this drug can be used to treat hot flashes and other symptoms of menopause or breast cancer. Effexor is made available in tablets or extended release capsules that are to be taken orally two to three times per day depending on the strength of your dosage. It is common for doctors to begin patients on a low dose of Effexor and adjustment is based on how your body and condition react to the medication. You should not stop taking Effexor suddenly, or double up doses to make up for those you have missed. If you are on extended release capsules, do not take more than one dose per day.
You will need to take Effexor with food to ensure that it absorbs properly. Try to take your medication around the same time every day, both to help you remember to take your dose and to help keep a continuous stream of medication in your system. You should swallow your prescription whole. Chewing or splitting the medication can cause you to absorb it too quickly, which may cause a negative reaction. Your doctor may instruct you to open your extended release tablets and mix the contents into applesauce if you have trouble swallowing pills. This mixture should not be made in advance, and should be taken immediately, followed by a full glass of water.
Dosing will vary based on the condition of the disorder being treated and how patients respond to the medication. For most adults Effexor is initially prescribed at 37.5 mg per day and increased weekly until a good balance is reached. Standard doses will range from 75-225 mg per day in most cases. Some severely depressed patients require doses up to 375 mg per day, but this should only be done under direct medical supervision. The minimum effective dose of Effexor is 37.5 mg per day. Doses should never exceed 400 mg per day.
Women should not take Effexor during the third trimester of pregnancy. Pregnant women may also see that they need to alter their dosage to account for the hormonal changes that occur within their body at this time. Pregnant women using Effexor late in their pregnancy have reported an increased need to hospitalize their infants after birth due to their need for respiratory support or tube feeding. Discuss these risks with your doctor so you can develop a solid plan to step down from your medication during this time.
Those with hepatic impairment may need to limit their use of Effexor to half of the standard dose for adults. This group may not be able to clear the medication from their system as effectively as other patients, increasing the risk of overdose. Similarly, patients with renal impairment may need to limit their dosing to half of the standard size to ensure that their condition is not made worse by an overwhelming presence of the medication. If you have either of these conditions, make sure your doctor knows before you start your Effexor prescription so that they can make the proper adjustments to your medication.
Elderly patients do not have a specific dosing restriction based on age, but caution should be taken when providing Effexor to this age group. Many people who are advanced in age report an increased risk of side effects and an increase in the severity of side effects when taking antidepressants.
Effexor Side Effects
The most common side effect associated with Effexor is nausea which occurs in 58 percent of users. This side effect can often be managed by making sure to take your medication with food and water, but your doctor should be informed if you cannot keep your nausea under control. Other common side effects include headache in 26.1 percent of users, dizziness in 24 percent, drowsiness in 23 percent, dry mouth in 22 percent, insomnia in 22.5 percent, nervousness in up to 21 percent, sweating in 19.3 percent, loss of appetite in 17 percent, body weakness in up to 17 percent, high blood pressure in 13 percent, ejaculation problems in 12.5 percent, anxiety in 11 percent, and shakiness in 10.2 percent of users. Inform your doctor if you develop any of these symptoms. Do not stop taking your medication unless your doctor tells you to.
Less common side effects of Effexor, occurring in 8-6 percent of users include diarrhea, yawning, chills, vomiting, indigestion, impotence and blurred vision. None of these side effects are dangerous, but they might affect your ability to function on a regular basis. Inform your doctor if any of these side effects persist throughout your prescription, or if they become worse at any time.
Additional side effects, occurring in 1-6 percent of users include decreased sex drive, infections, flushing, gas, unexplained changes in weight, abnormal dreams, high cholesterol, agitation, confusion, unusual thoughts, and increased urination or taste changes. Because these side effects are less common it is difficult to determine if these side effects are caused by an interaction with your medication or with another condition or if it is a side effect of Effexor itself. Inform your doctor if any of these side effects occur to determine if an alteration in your prescription is necessary.
In some patients, severe side effects have occurred. If at any time you experience suicidal thoughts or behavior, serotonin syndrome, extreme anxiety or agitation outside of your previous symptoms, hostility, engaging in unusual or dangerous activity, restlessness, extreme elation, hart palpitations, difficulty breathing or difficulty sleeping you should contact medical help right away. If at any time you notice unexplained hives, itching, swelling, or wheezing you may be suffering from an allergic reaction which could be life threatening. Contact emergency medical services and poison control as soon as possible.
Medications known to interact with Effexor include furazolidone, iproniazid, isocarboxaid, linezolid, methylene blue, metoclopramide, nialamide, pargyline, phenelzine, procarbazine, selegiline, tolxatone, tranylcypromine, and trifluoperazine. Inform your doctor about these or any other medications you might be taking so that you can adjust your doses to avoid a potentially serious reaction.
In some cases, you may need to take multiple medications together with Effexor, but you may need to adjust your doses to avoid an overdose or other severe reaction. These include acenocoumarol, amitriptyline, amoxicillin, anagrelide, ancrod, aspirin, atazanavir, bivalirudin, cilostazol, clarithromyicn, clopidogrel, danaparoid, defibrotide, eptifibatide, fluoxetine, haloperidol, heparin, imipramine, jujube, lamifiban, lexipafant, nefazodone, phenindione, rasagiline, ritonavir, sibrafiban, sumatriptan, tapentatol, warfarin, tramadol, vasopressin, xemilofiban and zolmitriptan.
You should limit your use of alcohol and tobacco while on Effexor, and avoid using these substances around the meal times when you will be taking your medication to avoid a potentially severe reaction. These substances increase your risk of cardiovascular events and other side effects which could be fatal.