Effexor

Effexor is the brand name for venlafaxine, an antidepressant in the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is approved for major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder in adults. It may be used off-label for other conditions, though indications vary by country and clinical guidelines.

Venlafaxine works by increasing levels of serotonin and norepinephrine in the brain through inhibition of their reuptake. At lower doses it primarily affects serotonin; at higher doses it also substantially inhibits norepinephrine reuptake and can have some activity on dopamine pathways in certain regions. The drug is rapidly absorbed and extensively metabolized in the liver to an active metabolite, O-desmethylvenlafaxine (ODV). The parent drug and the metabolite are cleared by the kidneys; metabolism can be slowed by liver impairment and older age.

Dosing is individualized and managed by a clinician. For many conditions, starting doses are moderate with gradual titration. Common daily dose ranges for adults span roughly 75–225 mg, with a maximum of about 375 mg per day for some regimens and indications. Effexor XR (extended-release) is typically taken once daily; immediate-release forms may be taken in divided doses. Doses should be increased slowly to reduce adverse effects and discontinuation symptoms.

Common adverse effects include nausea, dry mouth, decreased appetite, insomnia or sedation, dizziness, sweating, and sexual dysfunction. Venlafaxine can raise blood pressure at higher doses and carries a risk of serotonin syndrome when used with other serotonergic medicines. Discontinuation symptoms are possible if the medication is stopped abruptly. It should not be used with monoamine oxidase inhibitors and requires caution when combined with certain antidepressants, tramadol, or triptans. As with all medicines, consult a healthcare professional for personalized guidance.