EFFEXOR XR (Venlafaxine)
EFFEXOR XR (Venlafaxine) is a slow release capsule and comes in 37.5, 75, and 150mg sizes. It is a broad spectrum medication, which means it works by blocking reuptake of Serotonin (at 37.5 to 75mg) and norepinephrine (at 150mg+). Serotonin and norephinephrine are the two primary stress neuromodulators. Because Effexor XR works on both these neuromodulators, it is effective in treating anxiety and depression. When Effexor XR is taken, the brain levels of Serotonin and Norepinephrine are lowered if too high (as in anxiety), or raised if too low (as in depression).
Effexor XR has no significant drug/drug interactions and does not require dose decreases for the elderly.
HOW TO TAKE FOR ANXIETY/DEPRESSION
| Week 1 | 37.5 mg in a.m. (after breakfast) | |
| Week 2 | 75 mg in a.m. | |
| Week 3+ | 75 mg in a.m. if improving, if not, take 150 mg | |
| Day 1 | 37.5mg in am |
| Day 2 & 3 | 37.5mg in am and at suppertime |
| Day 4+ | 75mg in am and at suppertime |
| Day 1 | 37.5 mg in a.m. and at suppertime |
| Day 2 | 75 mg in a.m. and at suppertime |
| Day 3+ | 150mg in a.m. and 75 mg at suppertime |
PARTIAL DOSING
During transition, (if less than 37.5 or between 37.5 and 75mg is needed), capsules may be opened and used as a sprinkle form on any soft food. Sprinkled granules remain slow release unless bitten into.
PANIC PATIENTS NOTE:
This step is especially important in panic disorder where initial doses as small as 9mg may be needed. It is essential to minimize side effects with panic patients because of extreme sensitivity to side effects. The dose can usually be gradually increased.
DO NOT abruptly stop the medication. This can cause rebound symptoms such as muscle aches and nausea. When tapering the dose decrease by 37.5mg every 3 days.
WHAT IS THE BEST DOSE TO TAKE FOR ME?
Take enough, not too much! How much is that? I don’t know. Each person has to find the dose for him/her that achieves the goal of remission (completely back to normal functioning).
- If you have some side effects but they are mild – remain on dose schedule
- If side effects are bothering you – shift the dose time, split the dose or decrease the dose for 3-4 days, then try to go back up
- If you have taken it for 1-2 weeks and not seeing significant benefit – increase the dose
SIDE EFFECTS
| Fatigue, Sluggishness | First, shift the dose to evening meal. If still a problem, decrease the dose. |
| Delayed Orgasm | Change dosing time to right after sex. |
| Nervousness | Decrease or divide the dose, decrease caffeine intake. |
| Nausea | Take with food, decrease dose or split dose for 3-4 days. |
| Sweating | Take medication at suppertime, or decrease dose. Adding Cardura (a mild blood pressure medication) may help. |
| Increased blood pressure | This occurs occasionally in susceptible patients and is usually higher doses. Is easily managed by lowering dose, splitting dose, or adding Cardura. |
HOW DO I SWITCH FROM ANOTHER ANTIDEPRESSANT TO EFFEXOR XR?
Note: The most important rule of changeover is make only ONE change at a time. In other words don’t change the Effexor XR dose and SSRI dose both on the same day.
| Days 1-4 | 37.5 mg Effexor XR in a.m. and current dose of SSRI in evening |
| Days 5-8 | 37.5 mg Effexor XR in a.m. and decrease SSRI by ¼ – ⅓ |
| Days 9-12 | 75 mg Effexor XR in a.m. and SSRI dose not change |
| Days 13-16 | 75 mg Effexor XR in a.m. and decrease SSRI another ¼ – ⅓ |
| 2½ weeks | Re-evaluate – if all is going well, discontinue current SSRI and consider going up on the Effexor XR if needed for symptoms. |
3 thoughts on “How To Take Effexor (Venlafaxine)”
Thank you, BIG HELP!
I tooktook Prozax 20 mgs. 1 pill every other day (yes, subclinical)for almost 20 years and just recently my OBGYN changed me to Wellbutrin. The first problem came when the Pharmacy and the Dr. had a miscommunication about how I was to take it. The Dr. had told me that I would take (1) 100 mg pill everyday for 3 days and then switched to a dose of 300 mg once a day. The pharmacy filled it as taking (1) 300 mg a day. The first day I was so hyper I stayed awakealmost 24 hours. I realized that something was wrong,called the Dr.and yes I was to take the 100 mg ones for three days first. I took as prescribed and within 1 week I started exhibitingadverse reactions (agitation,crying, sleeplessness,anger and generalill feeling.) Today He prescribed Effexor 75 mg. The bottle has no other instructions than once a day. My question is, in your opinion are these two drugs so similar that I may have the same or worse symptoms? Believe me when I say that I was over the moon on Wellbutrin! I miss the mellow out effects of Prozacbut realize I have been on it a longtime and Menopause has brought more issues to the table that he feels that this drug will addressmore adequately. Thank you for addressing this.
My husband was prescribed Effexor XR for severe depression with anxiety disorder. He told me how he hated the medication the day before he killed himself. I link the drug to this as he has never indicated this before.