Effexor ( Venlafaxine ) Withdrawal

Effexor taper and withdrawal guidance.

About James Harper

Member of National Association of Alcoholism and Drug Abuse Counselors
Member of Florida Association of Addiction Professionals
Expert DNA Witness (Los Angeles, CA. Courts)
Speaker/Presenter for CME at Medical Colleges

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Effexor (Venlafaxine): A Comprehensive Guide

Effexor, the brand name for venlafaxine, is a prescription antidepressant that belongs to the class of serotonin-norepinephrine reuptake inhibitors (SNRIs). Approved by the U.S. FDA in 1993, Effexor was one of the first widely used SNRIs and remains a common treatment option for depression and anxiety.

Effexor is available in two main forms: Effexor (immediate-release) and Effexor XR (extended-release). The XR version is most commonly prescribed today because it provides smoother blood levels and fewer dosing requirements.

This guide covers everything you need to know about Effexor: how it works, its uses, dosage, side effects, withdrawal, comparisons, and important patient considerations.

Effexor withdrawal key facts.

1. What is Effexor?

Effexor is often considered a “dual-action” antidepressant because it influences both serotonin and norepinephrine in the brain. At lower doses, it primarily increases serotonin, while at higher doses it also strongly affects norepinephrine.

This dual effect makes it useful not only for depression but also for anxiety and panic disorders.

2. How Does Effexor Work?

Effexor works by blocking the reuptake of serotonin and norepinephrine, increasing their levels in the brain. This leads to:

  • Improved mood and energy
  • Reduced anxiety
  • Better concentration
  • More stable emotional regulation

3. FDA-Approved Uses

  • Major Depressive Disorder (MDD)
  • Generalized Anxiety Disorder (GAD)
  • Panic Disorder
  • Social Anxiety Disorder (SAD)

4. Off-Label Uses

Doctors may prescribe Effexor off-label for:

  • Migraine prevention
  • Hot flashes (menopause-related)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Diabetic neuropathy and chronic pain (less common than Cymbalta)

5. Dosage and Administration

Effexor is available in immediate-release (IR) and extended-release (XR) forms.

  • Effexor IR: 25 mg, 37.5 mg, 50 mg, 75 mg, 100 mg tablets
  • Effexor XR: 37.5 mg, 75 mg, 150 mg capsules

Typical dosing:

  • Start: 37.5–75 mg daily
  • Maintenance: 75–225 mg daily
  • Maximum: 375 mg daily (for severe depression, usually IR form only)

Effexor XR is taken once daily, while the IR version is taken 2–3 times daily.

6. Common Side Effects

  • Nausea
  • Sweating
  • Dry mouth
  • Dizziness
  • Insomnia
  • Constipation
  • Fatigue
  • Increased blood pressure (especially at higher doses)
  • Sexual dysfunction

7. Serious Side Effects

  • Hypertension (high blood pressure) — monitoring required
  • Increased risk of suicidal thoughts (especially under 25)
  • Serotonin syndrome (rare, but potentially life-threatening)
  • Eye pressure increases — can worsen narrow-angle glaucoma
  • Seizures (rare)

8. Drug Interactions

Effexor may interact with:

  • Other SSRIs or SNRIs
  • Triptans (migraine meds)
  • Blood thinners (increased bleeding risk)
  • MAOIs (dangerous interaction — must allow a 14-day gap)
  • Alcohol (increases sedation risk)

9. Effexor vs. Other Antidepressants

  • Effexor vs. Pristiq (Desvenlafaxine): Pristiq is the active metabolite of Effexor and may cause fewer variable effects.
  • Effexor vs. Cymbalta (Duloxetine): Cymbalta is also approved for pain conditions; Effexor is better studied for panic disorder.
  • Effexor vs. Zoloft (Sertraline): Zoloft is generally preferred for anxiety; Effexor is stronger at high doses for depression.
  • Effexor vs. Lexapro (Escitalopram): Lexapro often has fewer side effects; Effexor may be more activating.

10. Withdrawal and Discontinuation

Effexor is well known for difficult withdrawal symptoms, sometimes called “Effexor discontinuation syndrome.”

Symptoms include:

  • Dizziness and balance problems
  • Electric shock sensations (“brain zaps”)
  • Nausea
  • Headaches
  • Irritability and agitation
  • Vivid dreams
  • Fatigue

Because of its short half-life, Effexor requires a very gradual taper to minimize withdrawal effects. Some patients switch to fluoxetine (Prozac) briefly to ease discontinuation.

11. Special Considerations

  • Pregnancy & breastfeeding: Risks exist, but sometimes used if benefits outweigh risks.
  • Children/adolescents: Higher risk of suicidal thoughts, not first-line choice.
  • Older adults: May experience dizziness, blood pressure changes, or electrolyte imbalances.
  • Heart health: Monitoring blood pressure is important during treatment.

12. Effectiveness

  • Effexor is effective for both depression and anxiety.
  • At doses under 150 mg, it mostly acts like an SSRI; higher doses add norepinephrine effects.
  • Some patients find it more energizing than SSRIs.

13. Lifestyle & Supportive Care

  • Therapy (CBT, mindfulness, exposure therapy) works best alongside medication.
  • Exercise improves mood and reduces withdrawal severity.
  • Sleep hygiene helps manage insomnia side effects.
  • Support systems aid during withdrawal or long-term management.

14. Pros & Cons

Pros:

  • Effective for both depression and anxiety
  • Extended-release version simplifies dosing
  • More energizing at higher doses

Cons:

  • Notorious for difficult withdrawal
  • Can raise blood pressure
  • May cause sweating and sexual dysfunction
  • Higher side effect burden than some SSRIs

15. Patient Experiences

  • Many patients describe it as very effective for depression when SSRIs failed.
  • Commonly reported issue: severe withdrawal symptoms if a dose is missed or stopped suddenly.
  • Some patients feel more energized and motivated on Effexor compared to other antidepressants.

16. Long-Term Use

Effexor can be taken long-term, but patients should be monitored for:

  • Blood pressure changes
  • Cholesterol increases
  • Side effects like sweating or insomnia
  • Need for ongoing treatment vs. tapering

More About Effexor

Effexor (venlafaxine) is a powerful SNRI antidepressant effective for depression, anxiety, and panic disorders. Its dual serotonin and norepinephrine effects provide broad symptom coverage.

However, its reputation for challenging withdrawal and side effects like sweating, insomnia, and high blood pressure means it isn’t the right choice for everyone.

Under medical supervision, with careful dose adjustments and tapering strategies, Effexor can be an effective and life-changing medication for many patients.


Effexor withdrawal – How to taper Effexor is fully described in How to Taper Psychoactive Medication. The full step by step process in detail. Free assistance is also available if needed.
Effexor Withdrawal Symptoms – What are the symptoms of Effexor withdrawal described as well as how to eliminate Effexor withdrawal symptoms.
Effexor withdrawal – What is the Effexor withdrawal timeline? You will find that in How to Taper Psychoactive Medication. There is a timeline you should follow for a successful Effexor withdrawal.
Effexor withdrawal – Headache is all too common during Effexor withdrawal. Want the solution? It is found in How to Taper Psychoactive Medication.
Effexor withdrawal – Some have anxiety during Effexor withdrawal, and some have fatigue during Effexor withdrawal. How to Taper Psychoactive Medication gives the solutions.
Effexor withdrawal – Nausea during Effexor withdrawal is all too common. It does not need to happen. Read How to Taper Psychoactive Medication for the solution.
Effexor withdrawal – Do you want a list of virtually all Effexor withdrawal side effects? Not only does How to Taper Psychoactive Medication give the Effexor withdrawal side effects but offers solutions.

Effexor withdrawal – Brain zaps caused by Effexor withdrawal can be eliminated quickly. Yes, the solution is in How to Taper Psychotropic Medication.

The most debilitating Effexor Venlafaxine withdrawal side effect is something called brain zaps. An electrical jolt that usually starts at the base of the skull and feels like it runs into the brain. Effexor Venlafaxine brain zaps is the leading cause of people stopping the Effexor Venlafaxine withdrawal process and they go back on a higher dosage of the Effexor Venlafaxine in the hope of relief.

Nausea from Effexor Venlafaxine withdrawal – While at the store getting the omega 3, get a box of ginger tea. Drink at least 2 cups of ginger tea a day and the nausea should ease.

Doing the suggestion above will help you begin to feel better quickly but there are a few other things you will need to do for a successful Effexor Venlafaxine withdrawal.

Next – Go back up to the last Effexor Venlafaxine dosage you felt stable at. Hopefully, it was the last dosage you reduced from. If you were not stable when you reduced the last dosage of Effexor Venlafaxine, you need to consider going back up further on the Effexor Venlafaxine. Let your prescribing physician know what you are going to do. The sooner you go back up to the last dosage you felt stable on the Effexor Venlafaxine the better off you will be.

You may feel hesitant about going back up on the Effexor Venlafaxine dosage because you do not want to lose the ground you have gained but there really is not another option for you. The further you proceed doing what you have been doing the harder it will be to dig out of the Effexor Venlafaxine withdrawal side effects.

Again, go back up on the Effexor Venlafaxine and get stable. Get the book How to Taper Psychotropic Medication on Amazon and have a nice Effexor taper.

Effexor Venlafaxine Withdrawal Timeline

Effexor needs to be reduced by no more than 10% of the original dosage every 2 weeks. However, you should not reduce Effexor after 2 weeks if you are having Effexor withdrawal side effects. You need to remain on that dosage until you feel very stable.

In 2004, Jim Harper started a DNA testing laboratory with the hope of finding some answer for Effexor withdrawal based upon an individual’s DNA and how fast or slow they metabolized Effexor. The test results showed why some went into withdrawal quicker than other but no real answers for a more successful Effexor withdrawal.

In 2005, Jim began researching other areas that might help with Effexor withdrawal, and he looked at specific nutritional supplements. The first sign of success was found early on with this approach. Over the past 26 years Jim has continued to research and formulate new supplements as new evidence came to light. Basically, Effexor and other medications make certain genes and proteins become too active and this is part of what makes the Effexor withdrawal begin.

Bringing those genes and proteins back to a normal balance, while not changing how the Effexor metabolizes turned out to be the answer for an effecting Effexor withdrawal.
As of December 2024, our estimated Effexor withdrawal success rate is now around 90%.


Slow and steady will win this race!

There is Hope and There is a Solution

1. Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications

Studies on psychotropic medications decrease, discontinuation, or switch have uncovered withdrawal syndromes. The present overview aimed at analyzing the literature to illustrate withdrawal after decrease, discontinuation, or switch of psychotropic medications based on the drug class (i.e., benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonists, antidepressants, ketamine, antipsychotics, lithium, mood stabilizers) according to the diagnostic criteria of Chouinard and Chouinard [Psychother Psychosom. 2015;84(2):63-71],

Keywords: Antidepressant; Antipsychotic; Benzodiazepine; Discontinuation; Lithium; Mood stabilizers; Selective serotonin reuptake inhibitor; Serotonin noradrenaline reuptake inhibitor; Tolerance; Withdrawal.

2. Antidepressant Withdrawal and Rebound Phenomena

Background: Antidepressants are among the most commonly prescribed drugs worldwide. They are often discontinued, frequently without the knowledge of the prescribing physician. It is, therefore, important for physicians to be aware of the withdrawal and rebound phenomena that may arise, in order to prevent these phenomena, treat them when necessary, and counsel patients appropriately.

3. Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review

Background: Serotonin-noradrenaline reuptake inhibitors (SNRI) are widely used in medical practice. Their discontinuation has been associated with a wide range of symptoms. The aim of this paper is to identify the occurrence, frequency, and features of withdrawal symptoms after SNRI discontinuation.

Keywords: Adverse events; Antidepressant drugs; Desvenlafaxine; Discontinuation syndrome; Duloxetine; Levomilnacipran; Milnacipran; Serotonin-noradrenaline reuptake inhibitors; Venlafaxine; Withdrawal symptoms.

4. Withdrawal Syndrome Following Discontinuation of 28 Antidepressants: Pharmacovigilance Analysis of 31,688 Reports from the WHO Spontaneous Reporting Database

Introduction: Evidence is lacking on withdrawal syndrome related to individual antidepressants and relevant risk factors for severe reactions.

Objective: To ascertain whether antidepressants are associated with an increased reporting of withdrawal syndrome as compared with other medications, and to investigate risk factors for severe reactions.

5. Antidepressant withdrawal reactions

Antidepressants can cause a variety of withdrawal reactions, starting within a few days to a few weeks of ceasing the drug and persisting for days to weeks. Both tricyclic antidepressants and selective serotonin reuptake inhibitors cause similar syndromes, most commonly characterized by gastrointestinal or somatic distress, sleep disturbances, mood fluctuations and movement disorders. Most symptoms related to tricyclic antidepressant withdrawal are believed to be caused by rebound excess of cholinergic activity after prolonged anticholinergic effect on cholinergic receptors. (This situation is analogous to the adrenergic rebound that occurs after beta-blocker withdrawal.) Treatment involves restarting the antidepressant and tapering it more slowly. Alternatively, tricyclic antidepressant withdrawal symptoms often respond to anticholinergics, such as atropine or benztropine mesylate. Three case reports of antidepressant withdrawal are presented, including one featuring akathisia (motor restlessness) related to withdrawal of venlafaxine.

6. Antidepressants for people with epilepsy and depression

Background: Depressive disorders are the most common psychiatric comorbidity in people with epilepsy, affecting around one-third, with a significant negative impact on quality of life. There is concern that people may not be receiving appropriate treatment for their depression because of uncertainty regarding which antidepressant or class works best, and the perceived risk of exacerbating seizures. This review aimed to address these issues, and inform clinical practice and future research. This is an updated version of the original Cochrane Review published in Issue 12, 2014.

7. Venlafaxine

Infants receive venlafaxine and its active metabolite in breastmilk, and the metabolite of the drug can be found in the plasma of most breastfed infants; however, concurrent side effects have rarely been reported. Some experts feel that venlafaxine is not recommended during nursing,[1] but a safety scoring system finds venlafaxine use to be possible during breastfeeding.[2] Breastfed infants, especially newborn or preterm infants, should be monitored for excessive sedation and adequate weight gain if this drug is used during lactation, possibly including measurement of serum levels of desvenlafaxine (O-desmethylvenlafaxine), to rule out toxicity if there is a concern. Bruxism has also been reported in one infant. However, newborn infants of mothers who took the drug during pregnancy may experience poor neonatal adaptation syndrome as seen with other antidepressants such as SSRIs or SNRIs. Use of venlafaxine during breastfeeding has been proposed as a method of mitigating infant venlafaxine withdrawal symptoms,[3,4] but this has not been rigorously demonstrated.

8. Venlafaxine withdrawal syndrome

Dual-action antidepressants serotonin-norepinephrine reuptake inhibitors (SRNIs) are widely used to treat depression. Owing to its efficiency and safety, venlafaxine holds a prominent place in this group of depressants. Abrupt venlafaxine discontinuation involves a high risk of withdrawal syndrome. Mechanism of its development is similar to that of selective serotonin reuptake inhibitors (SSRIs), but of higher intensity. Venlafaxine withdrawal symptoms may include several somatic symptoms as well as several psychiatric symptoms. In some cases, symptoms may look like a stroke. A treatment option is re-inclusion of venlafaxine or a SSRI antidepressant. The paper presents the case of a 70-year-old patient who discontinued of her own accord to take venlafaxine, which she had been taking regularly at a daily dose of 225 mg for more than a year. A few hours after taking the last dose, withdrawal syndrome occurred with severe symptoms resembling a stroke. The patient was examined by a neurologist and the CT and laboratory parameters showed no irregularities. Diagnosis was made after psychiatric observation. Venlafaxine, 150 mg per day, was prescribed, the symptoms disappeared relatively quickly, and the patient fully recovered. Withdrawal syndrome is a real risk for each venlafaxine treated patient. The possibility of its occurrence should be always kept in mind and patients should be timely informed about it. In this way, the risk of venlafaxine withdraw syndrome could be reduced, unnecessary stress to patients prevented and the costs of medical treatment lowered.

9. Withdrawal symptoms of antidepressants

Withdrawal symptoms are encountered with both the classical anti-depressants, i.e. the tricyclic antidepressants and monoamineoxidase inhibitors, the modern antidepressants, i.e. the selective serotonin re-uptake inhibitors, and the new antidepressants such as venlafaxine and mirtazapine. The symptoms that are reported following the withdrawal of these drugs can be classified into 8 groups: influenza-like symptoms, psychic symptoms, gastrointestinal symptoms, sleep disorders, equilibrium disorders, sensory disturbances, extrapyramidal symptoms and other symptoms. It is characteristic of these symptoms that they appear 1-4 days after reduction of the dose or the last administration of the drug. They may also appear in the infants of mothers who used an antidepressant during the last phase of the pregnancy. It is important that the patient be informed accurately and carefully at the start and termination of any treatment with an antidepressant. In order to prevent withdrawal symptoms, it is advisable to reduce the dosage slowly if possible when the treatment is to be terminated.

10. Serotonergic anti-depressants and ethanol withdrawal syndrome: a review

Aim: To review laboratory findings on the effects of anti-depressant agents that interact with the serotonergic system on signs of ethanol withdrawal syndrome in rats.

Method: Adult Wistar rats received a modified liquid diet to produce ethanol dependence. Signs of ethanol withdrawal, locomotor hyperactivity, stereotyped behaviour, tremor, wet dog shakes, agitation, and audiogenic seizures, were evaluated for the first 6 h of ethanol withdrawal. The effects of the anti-depressants fluoxetine, venlafaxine, escitalopram, tianeptine, and extract of Hypericum perforatum (St. John’s wort) (HPE) were examined.

Results: Some beneficial effects of fluoxetine, tianeptine, HPE, escitalopram and venlafaxine on ethanol withdrawal signs were observed, ranked as follows: fluoxetine = tianeptine > HPE > escitalopram > venlafaxine.