Venlafaxine: Uses, Dosage & Side Effects

Venlafaxine is an antidepressant medication that’s used to treat depression and several anxiety disorders.

Venlafaxine is available as a tablet or extended-release capsule. Your healthcare provider may prescribe venlafaxine if you have been diagnosed with major depressive disorder (MDD), social anxiety disorder (SAD), generalized anxiety disorder (GAD) or panic disorder (PD).

Like many other antidepressants, venlafaxine works by changing the levels of certain chemicals, called neurotransmitters, in your brain.

When used as directed, venlafaxine is an effective treatment for depression and anxiety. Below, we’ve explained what venlafaxine is, how it works within your body and the most common uses for this medication.

We’ve also listed the most common side effects you may experience while using venlafaxine or similar medications to treat depression or anxiety.

What is Venlafaxine?

Venlafaxine is an antidepressant. It belongs to a class of medications referred to as SNRIs, or serotonin-norepinephrine reuptake inhibitors.

Currently, venlafaxine is approved by the FDA as a treatment for major depressive disorder, as well as the following anxiety disorders:

• Generalized anxiety disorder

• Social anxiety disorder

• Panic disorder

Venlafaxine is also occasionally used off-label as a treatment for migraines, diabetic neuropathy, posttraumatic stress disorder (PTSD), attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and hot flashes.

In women, venlafaxine may be used off-label as a treatment for premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome.

Currently, venlafaxine is sold in the United States as a generic medication and under the brand name Effexor XR®. 

Venlafaxine was previously sold as Effexor®, but this medication has since been discontinued from marketing. 

As an SNRI, venlafaxine works by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine. This effect increases the amount of serotonin and norepinephrine in your brain and body. 

Serotonin and norepinephrine both play important roles in managing your moods, thoughts and behavior. 

For example, serotonin is involved in regulating your moods, happiness and anxiety, as well as several aspects of your sleep-wake cycle. 

Research has found that low levels of serotonin are associated with depression.

Norepinephrine is involved in increasing attention, promoting focus and in storing memories. It also plays a role in your sleep-wake cycle. 

Low levels of norepinephrine are associated with a lack of energy, poor concentration and possibly depression.

Venlafaxine begins to inhibit serotonin and norepinephrine reuptake as soon as it’s absorbed by your body. 

However, it may take four to eight weeks for venlafaxine to produce improvements in your mood, thoughts and other depression symptoms.

Venlafaxine Uses and Dosages

Venlafaxine is prescribed to treat several mood disorders and anxiety disorders, including major depressive disorder and generalized anxiety disorder.

Your healthcare provider may first prescribe venlafaxine at a low to moderate starting dose, then adjust your dose over time based on your symptoms and response to this medication.

Before taking venlafaxine, you may need to undergo screening for mental health issues such as bipolar disorder. 

Below, you can find the typical dosages for venlafaxine as a treatment for depression and other mental health issues.

Venlafaxine Dosage for Depression

When used as a treatment for major depressive disorder, venlafaxine is prescribed at a starting dose of 75mg per day.

If you take the standard-release version of venlafaxine, you should take your medication in two or three divided doses throughout the day, with food. 

If you’re prescribed the extended-release version of venlafaxine (available as Effexor XR), you should take your medication in a single daily dose, with food, in the morning or evening.

In some cases, your healthcare provider may recommend starting treatment with venlafaxine at a lower dose of 37.5mg per day. 

You may be instructed to increase your dose after taking this medication for four to seven days.

Your healthcare provider may gradually increase your venlafaxine dose to a maximum of 225mg per day.

Venlafaxine Dosage for Generalized Anxiety Disorder

For generalized anxiety disorder, the extended-release version of venlafaxine is prescribed at a starting dose of 75mg per day.

In some cases, your healthcare provider may recommend starting treatment with venlafaxine at 37.5mg per day, then adjusting your dose after four to seven days.

Your healthcare provider may gradually increase your venlafaxine dose to a maximum of 225mg per day.

Venlafaxine Dosage for Social Anxiety Disorder

For social anxiety disorder, venlafaxine is prescribed at a dosage of 75mg per day. Studies do not show any improvements in social anxiety symptoms with higher doses of venlafaxine.

Venlafaxine Dosage for Panic Disorder

For panic disorder, venlafaxine is usually prescribed at a starting dose of 37.5mg per day. 

Your healthcare provider may then increase your dose of venlafaxine to 75mg per day based on your response to this medication. 

The maximum dose of venlafaxine for panic disorder is 225mg per day.

Venlafaxine Dosage for Specific Conditions

In some cases, such as if you have an existing health condition, your healthcare provider may prescribe venlafaxine at a reduced dosage. 

Venlafaxine is typically prescribed at a 25 to 50% lower dosage for people affected by hepatic impairment (reduced liver function) or renal impairment (reduced kidney function).

Make sure to inform your healthcare provider if you have any existing health conditions before using venlafaxine or other antidepressant drugs. 

Side Effects of Venlafaxine

Like other antidepressants, venlafaxine may cause side effects. The most common side effects of venlafaxine are:

• Nausea

• Somnolence (drowsiness, lethargy and excessive sleep)

• Dry mouth

• Sweating

• Abnormal ejaculation (difficulty ejaculating, or delayed ejaculation)

• Anorexia

• Constipation

• Erectile dysfunction

• Decreased libido

Venlafaxine may also cause other side effects, such as dizziness, headache, nightmares, loss of appetite, burping, gas, diarrhea, physical weakness, muscle tightness, twitching, frequent or difficult urination, hot flashes, chills, sore throat, enlarged pupils or ringing in the ears.

Some of these adverse effects may be more noticeable during the first few weeks of treatment with venlafaxine. 

It’s important to contact your healthcare provider if you develop severe or persistent side effects after you start using venlafaxine.

In rare cases, venlafaxine and other antidepressants may cause serious side effects or allergic reactions. 

Contact your healthcare provider immediately if you experience any of the following symptoms:

• Hives, rash or itching

• Purple spots or unusual bruising on your skin

• A fast, irregular or pounding heartbeat

• Shortness of breath, chest pain or difficulty swallowing

• Eye pain or redness that affects your eyes

• Severe sweating, confusion and/or fever

• Hallucinations or loss of consciousness

• Difficulties with physical coordination

Our guide to the side effects of antidepressants provides more information on the common side effects you may experience while using venlafaxine or similar medications. 

Venlafaxine Drug Interactions

Venlafaxine can interact with other medications, including other antidepressants and other drugs that increase serotonin levels.

In some cases, these interactions may cause serious, potentially life-threatening issues, such as serotonin syndrome. 

Serotonin syndrome consists of a range of mental and physical symptoms, including agitation or restlessness, diarrhea, hallucinations, loss of coordination, rapid heart rate, high blood pressure, overactive reflexes and an increase in body temperature.

Venlafaxine should not be used with serotonergic medications (medications that affect serotonin levels). Do not take the following medications or supplements while using venlafaxine:

• Selective serotonin reuptake inhibitors (SSRIs)

• Other serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Tricyclic antidepressants

• Lithium

• Antipsychotic drugs

• Tramadol for premature ejaculation

• Amphetamines

• Fentanyl

• Buspirone

• Tryptophan supplements

• St. John’s wort

Older antidepressants, such as monoamine oxidase inhibitors (MAOIs), can have physiological effects that persist for several weeks.

These medications can cause serious, potentially harmful interactions when used at the same time as venlafaxine or other antidepressants.

Common MAOIs include isocarboxazid (available as Marplan® and under other brand names), phenelzine (Nardil®), tranylcypromine (Parnate®) and selegiline (Emsam®).

Other common medications with MAOI effects that can have serious interactions with venlafaxine include linezolid and intravenous methylene blue.

You should not start treatment with venlafaxine or any other antidepressants if you have used a MAOI medication in the last 14 days. 

If you have recently stopped using venlafaxine, make sure to wait for at least seven days before using any MAOI medications.

To reduce your risk of drug interactions, make sure to fully inform your healthcare provider about your medical history, including any medications you currently take or have recently taken, before using venlafaxine. 

How to Use Venlafaxine

Venlafaxine is a simple medication to use. However, there are several things that you should be aware of before using this medication.

Use the tips and recommendations below to get the best results from venlafaxine:

• Follow the dosage prescribed by your healthcare provider. Make sure to check the dosage before taking venlafaxine. Do not exceed the venlafaxine dosage prescribed by your healthcare provider.

• Swallow venlafaxine whole, with water. Venlafaxine tablets and capsules should not be divided, crushed, chewed or dissolved in water. Make sure to swallow each tablet whole with fluid, such as a glass of water.

• Use venlafaxine at the same time every day. Standard-release venlafaxine should be taken two to three times per day. The extended-release form of venlafaxine can be used in the morning or evening. You should take venlafaxine with food.Make sure to take venlafaxine at the same time every day. Setting an alarm or leaving a reminder note near your medication may help you to take venlafaxine on time.

• If you miss a dose, take the missed dose as soon as you can. If it’s almost time for your next dose, just skip the dose of venlafaxine and continue using your medication as normal.You should not take a double dose of venlafaxine to make up for a missed or late dose.

• Avoid drinking alcohol while using venlafaxine. Drinking alcohol with venlafaxine can result in an increased risk of sedation and other side effects. As such, it’s best to avoid alcohol while you’re being treated with venlafaxine.

• Do not adjust your dosage or abruptly stop using venlafaxine. Stopping venlafaxine suddenly, or abruptly reducing your dosage of venlafaxine, may cause you to experience withdrawal symptoms.If you would like to stop using venlafaxine, make sure to talk to your healthcare provider before making any changes to your use of this medication.

• Store venlafaxine out of reach of children. It’s best to keep venlafaxine in its original container. Store your medication at room temperature in a secure location. Do not store venlafaxine in an overly hot or damp environment, such as a bathroom.

• Dispose of unused venlafaxine safely. If you have any unused venlafaxine tablets or capsules, do not dispose of them in the toilet. The FDA’s guide to disposing of unused medications explains how to safely get rid of unused or expired medications. 

Understanding Venlafaxine

Venlafaxine is a widely-used antidepressant that’s prescribed to treat depression and a range of anxiety disorders.

If you’re prescribed venlafaxine for depression or anxiety, it’s important to use it as directed and inform your healthcare provider if you experience any side effects. 

We offer venlafaxine online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

You can learn more about the treatment options for depression in our full list of antidepressants, or by accessing our free online mental health resources.