Disclaimer: None of the information in this article constitutes medical advice. All statements are merely the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Venlafaxine, alternatively referred to by its full chemical name venlafaxine hydrochloride or venlafaxine HCL for short, is a prescription medication approved by the FDA to treat depression and anxiety.
It's the generic version of the drug, and the branded version is called Effexor.
But is venlafaxine proven to be effective for both anxiety and depression? Does the drug have concerning side effects? Is the branded version more effective? And how do real users rate and describe its effects?
In this article we'll answer all of these questions and more, as we analyze clinical trials on venlafaxine to determine if it's effective for anxiety and depression.
We'll also discuss the risk of side effects, compare venlafaxine to Effexor, and feature patient reviews and ratings.
How Effective is Venlafaxine?
Venlafaxine has been studied in hundreds of clinical trials testing its effectiveness for reducing symptoms of depression and anxiety.
A clinical trial published in the Journal of Clinical Psychopharmacology evaluated whether venlafaxine was effective for treating major depressive disorder (MDD).
Patients were instructed to take venlafaxine or a placebo pill for 12 weeks.
Those taking venlafaxine experienced less depression throughout the trial, and the effects were “dose-related,” meaning that those taking higher doses felt more benefit (to a limit).
A 2009 medical review compared the efficacy of venlafaxine with other leading antidepressants.
The study authors noted that patients on venlafaxine for depression were 14% more likely to respond to treatment than patients on than selective serotonin reuptake inhibitors (SSRIs) for treating depression.
Venlafaxine was also found to be more effective for “treatment-resistant depression,” which is defined as depression which is non-responsive to other medications.
The drug is also effective for treating anxiety.
A meta-study analyzed 14 clincial trials on venlafaxine in adults with generalized anxiety disorder (GAD), and found it to be effective for most patients in the short-term.
Another study found that the extended release (XR) form of venlafaxine was effective both short-term and long-term for reducing symptoms of anxiety, and for treating patients diagnosed with both anxiety and depression.
We will conclude from the available research that venlafaxine is effective for treating both depression and anxiety, which is unsurprising given that the drug is approved by the FDA for both indications.
Does Venlafaxine Cause Side Effects?
As is the case with many prescription antidepressants, there is an increased risk of suicide when taking venlafaxine.
A “black box” warning appears on the drug’s FDA label indicating such.
This type of warning is the most severe warning issued by the FDA, indicating a potential side effect that could cause serious harm to a patient.
This suicide risk appears to be quite low, and is rare when compared to other side effects, but is definitely something that patients should discuss with their doctor, especially if they have a personal or family history of suicidal thoughts or attempts.
A medical review published in the Prescrire International journal concluded that venlafaxine is more dangerous than other antidepressants.
The researchers conducting the study found that venlafaxine caused an increased risk of cardiovascular disorders compared with SSRIs.
The study authors also found that venlafaxine overdoses were more likely to be fatal than SSRI overdoses.
A meta-study on venlafaxine found that the most common side effects of the drug are relatively minor, such as dizziness, nausea and sleepiness.
The above-linked study also found that sexual dysfunction was a side effect particularly experienced by men, and likely due to increased blood pressure, which is a potential side effect of the drug.
Overall, venlafaxine has a relatively concerning side effect profile in our opinion, and it may be worthwhile for patients with mild or moderate depression to speak with their doctor about medications with lower risks.
YouTuber Tries Venlafaxine
One of the most popular YouTube videos on venlafaxine is from Brei DelGiudice, who shares her experience after using the medication for three months:
Is the Branded Version Superior?
As noted in the intro section of this article, venlafaxine is the generic form of the drug, and the branded form is called Effexor.
Patients are often curious about which version is more likely to be safe and effective.
An extremely thorough medical review compared the effectiveness and safety of brand-name and generic drugs, and found that there was no added benefit, on average, to taking brand-name medications.
This means that generic venlafaxine should be just as effective as branded Effexor, but can be significantly cheaper depending on health insurance coverage.
The retail price of brand-name Effexor is currently around $700 according to SingleCare.
The retail price of generic venlafaxine is currently $6.20 at Cost Plus Drugs.
Does Venlafaxine Cause Withdrawals?
Venlafaxine appears to cause withdrawal symptoms if stopped abruptly.
A 2011 medical review titled “Venlafaxine withdrawal syndrome” found that there was a “high risk” of withdrawal syndrome, and that the medication had a greater risk of withdrawal symptoms than SSRIs.
The researchers even noted that symptoms of venlafaxine withdrawal may resemble a stroke.
Due to this risk of uncomfortable withdrawal symptoms, we strongly recommend that patients speak with their doctor if they’re planning to stop using venlafaxine.
A medical professional can set up a tapering schedule that increases the safety of the quitting process, and can minimize the risk of withdrawal symptoms.
A YouTube creator named Alexandra Stott shared her experience withdrawing from venlafaxine:
Patients Rate Venlafaxine
Drugs.com is a website that allows patients on prescription medication to rate and review the drugs they're taking.
We cannot verify the accuracy or authenticity of any reviews on this site.
Venlafaxine has been reviewed over 2,700 times on Drugs.com at the time of updating this article, and has an average review rating of 6 out of 10 for depression and 6.5 out of 10 for anxiety.
A top positive review of venlafaxine for depression is published by a user named “Dora” who gave the drug a 10/10 rating:
“I can gladly proclaim this medication saved my life in sooo many ways! I had never felt content until I took [venlafaxine]. The grass was greener, the music was even more beautiful, I am now kind and patient again; I am simply happy! I don't need to constantly seek out pleasurable things to make life more exciting anymore.”
A top negative review is written by a user named “Mistake” who gave the drug a 1/10 rating:
“I was put on venlafaxine in 2001, and soon became functionally narcoleptic and severely depressed.”
Venlafaxine ER vs. Venlafaxine IR
Venlafaxine may be prescribed in an extended release (ER) version or an immediate release (IR) version.
The ER version, also called venlafaxine XR, has a higher dosage than the regular version of the drug.
Whether or not a doctor prescribes the ER version depends mostly on patient history and response to the drug.
However, it’s worth noting that a medical study found venlafaxine XR to be “significantly more effective” than venlafaxine IR for treating major depression.
This is unsurprising given that higher doses of a medication should create a stronger biological effect.
Can You Drink on Venlafaxine?
According to the medication’s FDA label, alcohol increases the risk of fatal overdose from venlafaxine.
Even if this is a rare risk, it seems clear that alcohol increases the potency of the medication to a potentially unsafe degree, and it seems logical to avoid alcohol use while taking this drug.
The drug manufacturer recommends on the label that patients entirely avoid alcohol while using any form of venlafaxine.
It's extremely important given the negative interaction between venlafaxine and alcohol that patients are honest with their doctor about their alcohol intake.
Even moderate alcohol intake can increase the risk of negative health outcomes while taking venlafaxine.
For patients who regularly consume alcohol and are unable to stop, their doctor should be able to prescribe a different medication that does not have a negative interaction with alcohol.
How Does Venlafaxine Work?
Venlafaxine is a member of a drug class called serotonin and norepinephrine reuptake inhibitors (SNRIs).
This means that the medication slows the body’s ability to process and break down serotonin and norepinephrine, which allows these neurotransmitters to circulate in the brain at higher concentrations than they would otherwise.
Both norepinephrine and serotonin are associated with mood disorders.
Depressed and anxious patients may have naturally low circulating levels of these compounds, which venlafaxine may help normalize.
The most common class of antidepressants are called SSRIs, as referenced previously, and this class of drugs artificially elevates serotonin but not norepinephrine.
Our Mental Wellness Picks
Brightside Health is our top overall mental wellness pick.
Brightside is an online therapy and medication platform that connects patients with licensed therapists and psychiatrists from the comfort of their home.
A medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD.
Mindbloom is our top alternative mental wellness pick.
Mindbloom offers ketamine therapy, and over 88% of patients experienced relief of anxiety and depression symptoms in a clinical trial on the brand.
Venlafaxine Dosage
Venlafaxine is prescribed at a wide range of doses.
According to a 2024 medical review, the drug can be prescribed from 25 milligrams (mg) all the way up to 375 mg, which is considered the maximum effective dose.
Typically doses are divided throughout the day, so even patients on a relatively high dose like 300 mg would be taking a few pills throughout the day rather than the entire 300 mg dose in one sitting.
This may reduce the risk of side effects, and help to ensure that the drug is active in the body consistently throughout the day.
Doctors typically prescribe drugs at the lower end of the dosage range to see how a patient reacts. If the patient is unresponsive to a lower dose, they may gradually increase the dose to see if the treatment success improves.
