Venlafaxine: a clear, practical guide for patients

Many people stop venlafaxine too fast and get a nasty withdrawal. That single fact worries doctors and patients more than most side effects. If you or someone you care for is starting, switching, or stopping venlafaxine, this page gives real tips you can use today.

Quick facts

Venlafaxine is an SNRI antidepressant often sold as Effexor. Doctors prescribe it for major depression, generalized anxiety, panic disorder, and social anxiety. It can work faster than some meds for certain symptoms, but it can also raise blood pressure at higher doses. Expect mood benefits to begin after 2–4 weeks, with fuller effects by 6–8 weeks.

Typical dosing: extended-release (XR) tablets are common. Start low—often 37.5–75 mg daily—and increase based on response. Usual therapeutic range is 75–225 mg/day. Immediate-release versions exist but need more frequent dosing. Always follow your prescriber’s plan.

What to watch for

Common side effects include nausea, headache, dry mouth, insomnia or sleepiness, and sexual problems. High doses can cause a meaningful rise in blood pressure, so check your BP after dose increases. If you have new or worse mood changes, suicidal thoughts, or unusual behavior, contact your prescriber right away—especially if you are under 25.

Stopping venlafaxine suddenly often causes withdrawal symptoms: dizziness, electric-shock sensations, sweating, anxiety, and flu-like feelings. A slow taper over weeks or months usually prevents this. Never stop on your own.

Interactions matter. Avoid combining venlafaxine with MAOIs or starting them within 14 days of stopping venlafaxine. Watch for serotonin syndrome if mixed with other serotonergic drugs (triptans, certain pain meds like tramadol, St. John’s wort). Tell your doctor about all medicines and supplements you take.

Pregnancy and breastfeeding need a careful talk with your clinician. There can be risks to the baby and withdrawal-like issues in newborns. Often the choice balances maternal mental health and potential neonatal effects.

For practical help: take XR tablets once daily, usually in the morning. You can take it with or without food. If nausea hits, try taking it with a meal. If insomnia is a problem, ask if switching to an evening dose helps, but check side effects and blood pressure first.

Compare to SSRIs: venlafaxine may work better for some severe depression or certain anxiety symptoms, but it can cause more withdrawal and raise blood pressure. Your doctor will weigh pros and cons based on your history.

Final tip: keep a simple log—mood, sleep, side effects, and blood pressure readings. Bring it to appointments. That helps your prescriber adjust dose safely and spot problems early.