Effexor (venlafaxine) for anxiety: What you need to know

Effexor (venlafaxine) for anxiety: What you need to know

Reviewed by:
Anastasia Ruiz, MD
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April 15, 2024
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Key takeaways

Sometimes in life we experience stress,  anxiety, sadness, or low moods. It’s a part of being human. But if you experience these feelings frequently, and they’ve started to disrupt your day-to-day life, it might be a sign that you’re struggling with an depression or anxiety disorder.  

If this is something you’ve been living with, or if you’re not sure, but you’d like an answer, it could be time to talk to a professional, like a psychiatrist. They can help you understand your symptoms, and provide a diagnosis if they think you may have a condition. They’ll also work with you on a treatment plan that could include medication, like Effexor (a brand name for venlafaxine).

In this article, we’ll cover everything you need to know about Effexor—how it works, what it’s for, and how it compares to other medications.  

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What is Effexor and how does it work?

Effexor is the brand name for venlafaxine, an SNRI (serotonin-norepinephrine reuptake inhibitor), and the first of this kind of antidepressant. SNRIs reduce symptoms of anxiety and depression by increasing the levels of two chemical messengers (aka neurotransmitters) in your brain. Serotonin affects your mood, appetite, and sleep, while norepinephrine affects your alertness and attention. Normally, after these chemicals carry out their functions they’re reabsorbed by nerve cells. But SNRIs stop that from happening so there are higher amounts of serotonin and norepinephrine active in your brain.

If you’re curious about learning about other SNRIs, check out: Cymbalta (duloxetine) for anxiety

What conditions does Effexor treat?

Effexor has been approved by the (FDA) Food and Drug Administration for the treatment of:

Off-label uses

Effexor is also used to treat other conditions in what’s called an “off label” use, ” meaning a medication is prescribed for something other than its intended use, typically based on scientific evidence and the discretion of your healthcare provider.

Effexor’s off-label uses include:

How do you take it for anxiety and depression?

There are two versions of Effexor—an extended release form, known as Effexor XR, and an immediate-release form, commonly referred to as simply Effexor.  

Effexor XR is typically taken once a day with food. The starting dose for these extended-release capsules will be based on your doctor’s recommendation and what you’re taking them for.

The immediate-release form of Effexor is prescribed at a similar starting dose of 75 mg. However, because it doesn’t last in the body as long as Effexor XR, your daily dose may be split up into two or three smaller doses with breakfast, lunch, and dinner.  

If you miss a dose of Effexor IR or XR, you can take it as soon as you remember. However, if it is nearly time for your next dose, skip your missed dose.  

How long do I have to take it?

Effexor is safe to take long term. If you’re tolerating Effexor well and it’s helping you manage your anxiety or depression symptoms, you may opt to take it for several years based on assessment of benefits and risks.  

Even if (or when) you’re feeling better, your doctor may recommend you to continue medication. Healthcare professionals may suggest staying on it until your symptoms have been resolved for at least 6-12 months. In many cases, they’ll monitor you while you take the medication and after you are off of it for at least a few months in order to minimize the risk of your symptoms returning.  

Abruptly stopping can result in withdrawal symptoms known as antidepressant discontinuation syndrome. Withdrawal from Effexor can include flu-like symptoms, headache, restlessness, high blood pressure, and abnormal sensory disturbances. These symptoms usually appear eight to twelve hours after your first missed dose, and can last for up to two weeks or more.  

If you do decide to stop taking Effexor, your healthcare provider will help you minimize the chances of experiencing withdrawal and help you start a tapering plan, which means decrease your dosage gradually over time.  

To learn more about what happens when you go off antidepressants, check out: Going back on antidepressants after stopping

How long does it take for Effexor to work?

Like most antidepressants, Effexor requires a few weeks to produce noticeable changes in your mood, feelings, and thoughts. I am seeking help with anxiety and trying to understand the underlying cause and potential treatments. In some cases, it can take anywhere from 4-8 weeks to see the full benefit of the medication, though you may feel some relief sooner than that.  

After about 6-8 weeks of taking Effexor, you may feel its full effects. Your depressed mood and lack of interest in activities may start to improve, and general symptoms of depression may be under control.  

One thing to keep in mind when it comes to mental health treatment, including medication, is consistency. It's normal for it to take a little while for your brain to adapt to the changes and for you to start seeing a difference. So don't get discouraged if you don't notice immediate results, and let your doctor know how you’re feeling.

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Possible side effects

Effexor, like many other antidepressant and anxiety medications, can cause side effects. If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, reach out to your doctor. Your healthcare provider will help you minimize the risks of side effects and let you know about them before prescribing you medication.

Common side effects:

  • Nausea or vomiting
  • Dry mouth
  • Sweating
  • Tiredness
  • Trouble sleeping or change in sleep habits, or unusual dreams
  • Sexual dysfunction, including decreased sexual interest, erectile dysfunction, or trouble having an orgasm
  • Constipation
  • Loss of appetite
  • Tremors or shaking
  • Dizziness
  • Blurry vision
  • Feeling anxious, nervous, or jittery
  • Headache
  • Increased heart rate  

Serious side effects:

Call your doctor right away if you have one of these serious side effects. Call 911 if you feel your symptoms are life threatening.  

  • Acting on dangerous impulses
  • Aggressive or violent behavior
  • Increased suicidal thoughts for certain groups, like young adults and children
  • New or worsening anxiety or panic attacks
  • Agitation, restlessness, anger, or irritability
  • Increased risk of suicidal behavior in young adults *
  • High blood pressure
  • Mania
  • Seizures
  • Worsening glaucoma angle closure
  • Low sodium levels
  • Bruising easily
  • Frequent nosebleeds or bleeding from your gums while brushing your teeth or flossing
  • Dark, tar-like stool
  • Bleeding from wounds that’s hard to stop

For young adults and adolescents, there is a label warning for increased risk of suicidal thoughts and behaviors. This risk is minimized with regular visits with your psychiatrist who will provide you with best course of action if such side effect develops Effexor is generally not approved for use in people under 18 years old, as there may be an increased risk of suicidal thoughts and behaviors in young people who take Effexor.  

Other considerations when taking venlafaxine

Certain medications, vitamins, or supplements can change the way Effexor works in your body. This is referred to as a medication interaction. To help avoid interactions, your mental healthcare provider will ask you about what you’re taking. They can help you manage all of your medications carefully and let you know they may affect Effexor and vice versa.

Medications you should not use with Effexor or be mindful of include:

  • NSAIDs, such as aspirin, ibuprofen, or naproxen: These over-the-counter or anti-inflammatory drugs may increase the risk of bleeding.
  • Monoamine oxidase inhibitors (MAOIs), including linezolid and methylene blue: Taking these two medications together too close in time may cause serious or life threatening side effects, including sudden changes in your heart rate or blood pressure, confusion, and passing out.
  • Stimulants, such as phentermine, Adderal, vyvanse : Using venlafaxine with drugs such as phentermine these may lead to excessive weight loss, serotonin syndrome, and heart problems such as rapid heart rate and high blood pressure. Serotonin syndrome is a rare but serious condition that happens when you have too much serotonin in your body, usually caused by taking medications that affect serotonin levels, including other SSRIs and SNRIs.

Should I take Effexor?

Effexor can be effective in treating both anxiety and depression and has been approved by the FDA. If you think you may have depression or anxiety and that Effexor may be able to help you manage your symptoms, talk to a mental health professional. Only you and your doctor can decide whether it’s a good part of your treatment plan.

Regardless of which medication is right for you, the first step in anxiety and depression treatment is to clarify and confirm your diagnosis. A psychiatrist can help you talk about what you’re struggling with and figure out what it is you’re feeling. At Talkiatry, we specialize in treating anxiety, depression and more. If you are interested in learning about treatment options from one of our psychiatrists, begin by taking our online assessment.    


Here are more answers to all your question about Effexor.

How long does it take for Effexor to get out of your system?  

It takes 2-3 days for Effexor to completely leave your system so it’s important to take your medication consistently in order to help with your symptoms. This can also help minimize your chances of experiencing withdrawal symptoms if you miss a dose.

Does Effexor make you gain weight?

Effexor may cause weight gain or weight loss. One study showed people taking this medication gained more than 7% of their body weight while other clinical trials showed negligible weight changes, with children and adolescents actually gaining less weight than their peers of the same age and gender would typically gain.  

What are other anxiety medications?

In addition to SNRIs, there are several other types of medications that can effectively treat anxiety symptoms. These include selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), tricyclic antidepressants (TCAs), benzodiazepines like Xanax (alprazolam) beta-blockers, and more. Finding the best anxiety medication depends on several factors, like potential side effects, your health history, and your treatment goals. A mental health professional like a psychiatrist will take these into account to determine what works for you.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
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Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Anastasia Ruiz, MD

Doctor Ruiz is a board-certified psychiatrist physician who specializes in psychiatric diagnosis and treatment in anxiety disorders, mood disorders, trauma and stressor related disorders, ADHD, and pregnancy related psychiatric conditions.

Dr. Ruiz received her bachelor’s degree in chemistry, graduating from the Honors College with Magna Cum Laude. She later completed four-years of medical school at Texas Tech University Health Sciences Center, and an additional four-years of psychiatric residency training. Dr. Ruiz has a diverse experience in psychiatry, including working in psychiatric hospitals, outpatient clinics, IOP, PHP, emergency rooms, and academic teaching. Dr. Ruiz is up to date on literature and current treatment guidelines. She has authored research publications. She has received recognition and awards including the AWP International Fellowship Award and the ADMSEP Innovations Award.

Dr. Ruiz's practice focuses on a combination of medication management and therapy, as research demonstrates that this results in better outcomes.

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