Effexor's pros and cons:

Effexor's Pros: There are two last resorts among the modern meds to cure the deepest, blackest depression when your doctor is just switching you from one horsie to another on the med-go-round:  Effexor XR (venlafaxine hydrochloride) and Remeron (mirtazapine). Either in combination with an antipsychotic would really get you out of that hole of despair, but first you should throw away every mirror and scale in your house and buy expandable clothing.  But for deep, despairing clinical depression that needs to respond to the standard tweaking of the three most popular neurotransmitters, Effexor XR (venlafaxine hydrochloride) often pulls people out of the abyss.

Effexor's Cons: For many people Effexor XR has the absolute worst discontinuation syndrome of an antidepressant. Effexor (venlafaxine hydrochloride) is a medication people utterly loathe to have taken. It is not uncommon for someone to fire doctors during or immediately after they quit taking Effexor XR(venlafaxine hydrochloride).

Effexor's Typical Side Effects: The usual for SSRIs and NRIs -  headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido and a host of other sexual dysfunctions. Most everything but the weight gain and sexual dysfunctions usually goes away within a couple of weeks.  Although some women will notice that the sexual side effects will diminish above 200-225mg a day when the norepinephrine kicks in.  Maybe.

For tips on how to cope with these side effects, please see our side effects page.

Effexor's Not So Common Side Effects: Increased or lowered blood pressure, sweating, farting, anorexia, twitching, shock-like sensations. 
Also alcohol intolerance and/or alcohol abuse. So Effexor XR (venlafaxine hydrochloride) is going to be just the thing to talk about at AA meetings. 
I used to have these last two listed as rare side effects, but I've received way too many e-mails and have read far too many similar reports on various other sites after putting up this page about both of them.  As is often the case here, the anecdotal evidence will often trump what is in the US PI Sheet.  Best guess to date as to why both of these side effects can happen - Paul of Leeds (in the U.K.) posits that Effexor's broad spectrum use of liver enzymes probably interferes with alcohol clearance and tolerance, thus leading to the type of alcoholism that affects people without the proper enzymes to effectively metabolize alcohol.  Between that and the way Effexor XR works your liver, you're probably better off giving up booze entirely if you're taking this med. 
These may or may not happen to you don't, so don't be surprised one way or the other.  Although I make no promises about the alcohol abuse

Effexor's Freaky Rare Side Effects:  Someone's reflexes increased and someone else's breasts got bigger, proving that there is no pleasing some people. Someone else's hair changed color and, really, no Revlon was involved. But the most disturbing freaky rare side effect with Effexor XR (venlafaxine hydrochloride) is what Wyeth disingenuously calls "withdrawal syndrome," that once you acclimate to Effexor (venlafaxine hydrochloride) you are basically hooked for life.  If not on Effexor XR then at least on some SSRI to take the worst of the edge off.  The discontinuation syndrome never goes away if you try to stop. For someone with unipolar depression that's a pain in the ass, but something you might be able to work around barring any really adverse side effects, but for someone who is bipolar you can be royally screwed because Effexor XR (venlafaxine hydrochloride) can really aggravate mania and especially rapid cycling.
You aren't going to get these. I promise..

Effexor's Half-Life & Average Time to Clear Out of Your System: Effexor (venlafaxine hydrochloride) does the double metabolism trick, so its half-lives are 3-7 hours and 9-13 hours. That means the combined half-life is anywhere from 12-20 hours, so it takes anywhere from two to five days to clear out of your system.  This is a huge part of why Effexor's discontinuation syndrome is so harsh. No popular SSRI does the double metabolism, and the half-lives of each metabolism is so bloody short. So while you clean out of one metabolite, you still have another one in your system. Your body is completely confused! Wyeth states in the pharmacokinetics section that there's only one active metabolite worth mentioning. Who the hell knows about other metabolites and what part they play in Effexor's discontinuation syndrome, or how long you should take in stepping down your dosage!

How to Stop Taking Effexor: Unless you need to discontinue Effexor XR at a more rapid rate, your doctor should be recommending that you reduce your dosage by 37.5mg a day every week if you need to stop taking it, if not more slowly than that.     For more information, please see the page on how to safely stop taking these crazy meds.   You shouldn't be doing it any faster than that unless it's an emergency. Yes, that means if you've maxed out at 375mg a day it'll take 10 weeks to get off of Effexor (venlafaxine hydrochloride). Believe me, it's better that way.  You can try it faster and hope it works out.  The odds are with you, but it's hardly a sure thing.  Once you get down to that last 37.5mg a day you have several options:

• If the discontinuation symptoms you're experiencing are mild, if you're experiencing any at all, then you may as well stop taking it.  You're in the plurality of people who have taken either version of Effexor who could stop taking Effexor (venlafaxine) without too much of a hassle.
• If the brain zaps or shivers and other discontinuation symptoms are still bad you can try taking one 37.5mg capsule every other day, or getting a prescription for generic venlafaxine in the immediate-release form and working your way down.  As immediate-release venlafaxine comes in a variety of dosages you have all sorts of ways you and your doctor can work out a discontinuation schedule from there.
• If you still can't stop taking it at a low dosage, you and your doctor may want to try Prozac (fluoxetine) prescription or samples.  Generic fluoxetine will even do.  10mg a day is all you should need.  Even with the proper discontinuation stopping the last 37.5mg can be hellish.  Taking two weeks worth of Prozac (fluoxetine) will make the discontinuation a lot easier.  So when you're off of Effexor and you cannot function, get on the Prozac for a week or two, then stop taking the Prozac.  By that time you should find you'll have either no discontinuation syndrome, or it won't be nearly as bad.
• If worse comes to worst, there's always the liquid Prozac.  Then you can work your way down from the equivalent of 10mg, or higher if 10mg was too low, to ever-so-slowly try to wean yourself off of the serotonergic part of Effexor that had its claws in you. 

If you've worked your way up to a particular dosage, it's usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.

Have questions about Effexor?  Want to read about experiences other people have had with Effexor? Check out our Effexor Board.

Manufacturers: Wyeth

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Created Monday, November 10,2003

Last updated Saturday, May 15, 2010

Copyright © 2003 - 2010 Jerod Poore. All rights reserved.

Almost all of the material on this site is copyright © 2002, 2003, 2004, 2005, 2006, 2007 and 2008 Jerod Poore. Except, of course, the PI sheets, those are the property of the drug companies who developed the drugs the sheets are about.  And any documents that are written by other people which may be posted to this site will remain the property of the original authors.  You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder.  That's usually me, so just ask first.  That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that's OK to just do.  Go for it!  Please.  As long as you include this copyright notice and the following disclaimer, I'm cool with it.

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