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Effexor Side Effects and Effexor Mania: Major Risks of Effexor Use

This entry was posted in Antidepressant and tagged , on by .
Medically Reviewed Fact Checked

Last Updated on July 25, 2022 by Chris Weatherall

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Venlafaxine or better known by its brand name, Effexor, is an antidepressant and nerve pain medication. In this in-depth blog post, we review why there is an ever-growing need for qualified rehab professionals who offer Effexor tapering. Within the larger scope of mental health treatment, there is a deeper need to more thoroughly evaluate a person’s life situation before prescribing antidepressant medications.13

There are many factors — other than a medication deficiency — that can cause depression: impaired hormonal states, nutrient deficiencies, adrenal fatigue, lack of exercise, failed life aspirations, and more.14

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tapering off effexor
Alternative to Meds has been primarily invested in antidepressant withdrawal for over 15 years. Using Holistic and Environmental Medicine, we have published evidence decisively showing that well over 77% of clients at the center suffer from fewer symptoms and feel better than they ever did while still medicated. Guiding our clients on a path of better health and what we call natural mental health is our primary goal.
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If you have been diagnosed with depression or anxiety disorder, you are far from alone. Together, depression and anxiety disorders make up the most commonly treated group of mental disorders in the United States—18.1% of the adult population (or about 40 million people) are experiencing anxiety disorders at any given time. In comparison, 6.7% (about 16.2 million people) experience a depression event in a given year. Fortunately, research has proven that these disorders are highly treatable, which has resulted in ongoing studies regarding the efficacy of several prescription medications.

However, many commonly prescribed antidepressants, such as Effexor, bring a long list of side effects and may even cause withdrawal symptoms when it is time to stop taking the medication. For that reason, it is important not to overlook natural remedies and alternative therapies to help those experiencing depression and anxiety. In this guide to Effexor use, side effects, mania, and withdrawal symptoms—will address these issues as they apply to one of the most commonly prescribed antidepressants: Effexor.

Prescription Drugs to Treat Depression and Anxiety

While there are multiple types of depression and anxiety disorders, physicians generally accept the theory that each may alter the brain’s delicate chemical balance. When an imbalance occurs, common symptoms of depression, anxiety, or both may be present. As a result, most pharmaceuticals endeavor to address the chemicals of the brain.

After much research and an exhaustive approval process, multiple prescription drug manufacturers have developed medications designed to restore the brain’s chemical balance; some are medications that target depressive disorders such as major depressive disorder and persistent depressive disorder. Other medications target anxiety-related disorders such as generalized anxiety disorder (GAD), panic disorder, social anxiety, obsessive-compulsive disorder, and those approved for the treatment of both.

Some major types of antidepressant and anti-anxiety medications include:

  • Benzodiazepines – These medications treat anxiety disorders and include Xanax (alprazolam), Klonopin (clonazepam), and Valium (diazepam). Benzodiazepines slow down the nervous system rather efficiently, making them ideal for short-term use. However, they are extremely physically addictive.
  • Selective Serotonin Reuptake Inhibitors (SSRIs) – These medications are approved to treat both anxiety and depression. SSRIs include Prozac (fluoxetine), Lexapro (escitalopram), Paxil (paroxetine), and Zoloft (sertraline). They work by inhibiting the reuptake or reabsorption by the body of serotonin, a major mood chemical. Blocking reuptake makes more serotonin available to the brain and thus improves mood.
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – Antidepressants such as Effexor (venlafaxine) and Cymbalta (duloxetine) are SNRIs. These medications also treat both anxiety and depression and work similarly to SSRIs. However, SNRIs also inhibit the reuptake of norepinephrine, another major mood chemical.

About Effexor

As the first discovered member of the SNRI class of antidepressants, Effexor was first approved in 1993 and primarily used to treat major depressive disorder. Initially, Effexor was produced solely in this form by the Wyeth company. When researchers discovered that the large amount of Effexor necessary to reduce symptoms adequately was best ingested over time, the Wyeth company began manufacturing an extended-release form in 1997.

Today, Pfizer makes only the extended-release version with the same active ingredient—venlafaxine. As a result of the switch to extended-release dosing and the unique properties of venlafaxine, dose sizes for Effexor are higher than those of other antidepressants. Currently, the drug is available in 150 mg, 75 mg, and 37.5 mg capsules, all of which must be taken with food to prevent nausea due to the high dosage. The maximum recommended daily dose is 225 mg, with physicians and patients working together to gradually increase the recommended starting dose of 35 to 75 mg per day up to the ideal dose.

How Does Effexor Work?

Depression and anxiety are associated with low levels of certain mood chemicals within the brain. As a serotonin-norepinephrine reuptake inhibitor, Effexor works to block the body from reabsorbing two key neurotransmitter chemicals—namely, serotonin (known as the “feel-good chemical”) and norepinephrine (known to affect energy and an alert feeling). These two neurotransmitters help the brain cells communicate with one another by acting as chemical messengers, affecting mood.

While researchers are not fully certain how the nerve signal transfers associated with these two neurotransmitters operate, preventing reabsorption of both effectively boosts the amount of each available to the brain. By blocking reuptake by other cells and providing a larger amount of norepinephrine and serotonin to the brain, SNRIs such as Effexor can help prevent depression and anxiety. SNRIs are a dual inhibitor. They are purportedly more effective than SSRIs at treating depression; however, the evidence remains unclear, and individuals may respond differently to SNRIs and SSRIs depending on their situation.

What Disorders Can Effexor Treat?

As an SNRI, Effexor XR is approved to treat multiple depression and anxiety-related disorders in adults by improving mood, energy level, and even your interest in daily living activities. However, the FDA has mandated a black box label for the drug, warning of increased suicidality in patients under 25; thus, approved treatments are for adults over 25 only.

Currently, Effexor is used to treat the following disorders:

• General Anxiety Disorder
GAD occurs when a person experiences excessive anxiety, worry, and other symptoms for six months or more. Additional symptoms can include:

  • Fatigue
  • Restlessness or inability to sleep
  • Sleep disturbances
  • Inability to concentrate
  • Irritability
  • Muscle tension

• Major Depressive Disorder
Major depressive disorder, also known as MDD, is perhaps best known simply as depression. While the primary symptom of depression is feeling depressed, sad, or even empty, many people with depression also feel worthless, hopeless, or suicidal. In addition, many people experience:

  • Eating or sleeping more or less than usual
  • Low energy
  • Nervous energy and agitation
  • Thoughts of death and dying

• Panic Disorder
Panic disorder involves sudden, repeated feelings of intense anxiety, fear, and panic. Over time, an individual can develop feelings of fear in anticipation of experiencing the next panic episode. Symptoms include:

  • Chest pain
  • Heart palpitations
  • Dizziness
  • Shortness of breath
  • Sweating
  • Nausea

• Social Anxiety
Individuals experiencing social anxiety primarily present as fear of being judged by others. The most common symptoms include:

  • Sweating
  • Shaking
  • Nausea
  • Flushing
  • Difficulty speaking

Off-Label Uses

Physicians can prescribe Effexor for other common uses aside from those approved by the FDA. However, these physicians must be able to demonstrate thorough reasoning for such prescriptions. Currently, Effexor is sometimes prescribed for off-label uses, such as the treatment of these disorders:

  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PDD)
  • Hot flashes
  • Migraine prevention
  • Diabetic neuropathy

What Are Some Effexor Side Effects?

While Effexor can prove effective for the above conditions, like many other prescription medications, it comes with a host of potentially negative side effects. Many Effexor side effects can be described as minor but may make taking the medication less desirable than the depression or anxiety symptoms.

General side effects tend to decrease over time and can include:

  • effexor side effectsHeadache
  • Nausea
  • Sweating
  • Diarrhea
  • Nervousness
  • Restlessness and insomnia
  • Fatigue

Other side effects, such as increased blood pressure, and sexual side effects such as delayed orgasm and decreased libido, may be more lasting. Other side effects are much more medically significant and, while rare, can pose severe health risks.

Serious Effexor side effects include:
  • Dangerously increased heart rate
  • Changes in urination and kidney function, including increased urination or difficulty urinating
  • Low sodium levels, indicated by headache, difficulty focusing, and weakness
  • Increased bleeding, including gastrointestinal, vaginal, and other forms of excessive bleeding
  • Serotonin syndrome—a dangerously high level of serotonin that can cause shivering, fever, seizures, and death
  • Increased suicidality, particularly in individuals under age 25
  • Mood “switching,” also known as Effexor mania

Effexor Mania

One of the unique side effects of Effexor use is mood “switching,” perhaps better known as Effexor mania. In Effexor mania, some patients experiencing depression, anxiety, or other related mood disorders initially experience mood modulation after using SNRI medications such as Effexor. However, there can be mood “switches” from a depressive state to a manic state very similar to the mania experienced during bipolar disorder.

Symptoms of Effexor mania include:
  • Decreased need or desire to sleep
  • Increased energy and agitation
  • Abnormal jumpiness, or a “wired” feeling
  • Racing thoughts
  • Increased distractibility
  • Increased talkativeness

In a study of 21,000 adults 1 treated for major depression, researchers found that Effexor seemed to increase mania instances by as much as 35% up to 24 months after the first dose. However, it is worth noting that many of these people may have had pre-existing bipolar disorder or a family predisposition to experiencing mania. In addition, the study consisted of a large group of adults and noted that the peak age for Effexor mania was between 25 and 34.

Teenage and adolescent individuals with depression appear even more likely to experience Effexor mania. While many of these cases may be attributed to previously undiagnosed bipolar disorder, some occur with no other bipolar disorder symptoms. Cases have been noted in elderly individuals as well, resulting in an overall rate of Effexor mania resting at 5% to 6% of all individuals taking the drug.

Quitting Effexor and Effexor Withdrawal Symptoms

effexor withdrawal symptomsAs a result of the above side effects, some patients experiencing multiple minor side effects, as well as those experiencing more severe side effects, may choose to discontinue use altogether. In these cases, stopping use can cause Effexor withdrawal symptoms to occur. Worse, stopping use abruptly or without medical oversight can cause severe, potentially dangerous, and even life-threatening Effexor withdrawal.

Symptoms of Effexor withdrawal can begin as soon as a few hours after the last dose, depending on the regular dose taken as well as each individual. While most minor withdrawal symptoms can dissipate over the course of a few days, other severe withdrawal symptoms have been known to continue for weeks or months.

Common Effexor withdrawal symptoms include:
  • Insomnia
  • Migraines
  • Fever
  • Chills
  • Diarrhea
  • Fatigue
  • Brain zaps—electrical buzz or sensation within the head and neck
  • Brain fog

It is crucial to avoid halting Effexor suddenly to avoid dangerous or life-threatening withdrawal symptoms that require medical assistance or cause you to take Effexor again. Instead, taper back on the medication gradually. Also, most people can benefit from seeking professional management of the medication and its withdrawal symptoms via a professionally guided program.

Effexor Alternatives

holistic alternatives to effexorIf you are experiencing some of the above-listed symptoms of major depression, GAD, social anxiety, panic disorder, or one of the other off-label conditions commonly treated by Effexor, alternatives may provide a viable solution. Similarly, if you are taking Effexor and experiencing negative side effects—including Effexor mania—it may be time to consider an alternative. However, it is important to safely taper off Effexor and consult a physician regarding all alternative options.

Then, you may begin to consider some of the natural methods of achieving mental health offered here at Alternative to Meds Center. Depending on your depression or anxiety symptoms, holistic methods can help you manage these disorders and avoid the many negative side effects of taking Effexor and other prescription antidepressants. Ultimately, Alternative to Meds Center can help you safely and comfortably cease Effexor use and improve your mental health via proven natural methods.

1. Reinberg S "Some Antidepressants, Bipolar Disorder Linked?" WebMD {cited 2021 May 30]

Originally Published Dec 23, 2020 by Lyle Murphy

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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