Effexor for Depression: What to Know About How Venlafaxine Works
Key takeaways:
Effexor (venlafaxine) is a medication that treats depression and anxiety. It works by increasing the amount of serotonin and norepinephrine in your brain. It also has some effects on dopamine.
Effexor is usually started at a dose of 75 mg per day. However, many people end up taking higher doses. The best dosage for you will depend on the severity of your symptoms and how you respond to the medication.
While effective, this antidepressant doesn’t work right away. It can take 4 to 8 weeks before you feel the full effects of Effexor on your mood. It’s important to take Effexor consistently for the best results.
Table of contents
Effexor (venlafaxine) is a prescription medication that treats depression. But Effexor has a few different roles. It can also manage conditions such as social anxiety disorder, generalized anxiety disorder, and panic disorder.
Effexor’s effects are tied to its influence on neurotransmitters in your brain. Neurotransmitters are chemical messengers that are responsible for communicating instructions between brain cells, muscle cells, and more. They play an important role in your mental health, movement, and even digestion. Because of this, it’s not ideal when they’re in short supply.
In some cases, depression can set in when the amount of certain neurotransmitters in your brain are too low. By taking a medication like Effexor, these neurotransmitters can become more plentiful and alleviate symptoms you may be experiencing.
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Do serotonin and norepinephrine affect mood?
Yes. Serotonin, norepinephrine, and dopamine are neurotransmitters that can affect your mood. They also have other effects on brain function. For instance:
Serotonin helps regulate behavior, mood, and memory.
Norepinephrine plays a role in mood, emotions, motivation, and cognition.
Dopamine is involved in pleasure and motivation.
Many experts believe that depressive symptoms can develop when these neurotransmitters are too sparse or out of balance. This is why antidepressants such as Effexor aim to boost the levels of some of these chemicals.
How does Effexor treat depression?
Effexor is a serotonin and norepinephrine reuptake inhibitor (SNRI). SNRIs are medications that treat depression and anxiety by affecting the activity of serotonin and norepinephrine in your brain. Effexor also has mild effects on dopamine.
If you have low levels of serotonin, norepinephrine, or another neurotransmitter, depressive symptoms are more likely to affect your life. Effexor helps improve the amount of serotonin, norepinephrine, and dopamine at your brain’s disposal. This can lead to improvements in mood, thinking, and even physical symptoms of depression.
Keep in mind: Depression is a complex condition that doesn’t have a single cause. Your genetics and life circumstances can each be significant contributing factors. Trauma, stress, and other medical conditions are also associated with depression. However, in many cases, your brain chemistry stands at center stage.
What are the main Effexor dosages for depression?
Effexor comes in two different versions — an extended-release (ER/XR) form and an immediate-release (IR) form.
The usual starting dose of Effexor XR (venlafaxine ER) is 75 mg taken once daily with food. If you need more relief, your healthcare provider may slowly increase your dose up to 225 mg per day. In some cases, your dosage may go up to 375 mg per day.
If you’re taking Effexor IR, often plainly called “Effexor,” you’ll likely take the same daily dosage as the ER version. But Effexor IR doesn’t last as long in the body as Effexor XR. Your daily dosage will be split up into two or three smaller doses. For example, if your recommended daily dose is 225 mg, you may be instructed to take 75 mg of medication with breakfast, lunch, and dinner.
How quickly does Effexor work for depression?
Most antidepressants don’t work immediately. They require some patience.
In most cases, people need to take SNRIs like Effexor consistently for about 4 to 8 weeks before they really start working. But some people start to feel positive changes — such as improvements in energy levels — within 1 to 2 weeks.
How is Effexor different from other antidepressants?
Traditional first-choice antidepressants — called selective serotonin reuptake inhibitors (SSRIs) — are designed to only affect serotonin. Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine) are common SSRIs. By comparison, Effexor has effects on norepinephrine and dopamine in addition to serotonin.
Effexor also has different side effects than SSRIs. Effexor can cause high blood pressure, especially at higher dosages. SSRIs aren’t linked to this risk. Effexor may also dilate your pupils, elevate your heart rate, and cause constipation.
Non-SSRI antidepressants
SSRIs and SNRIs aren’t the only antidepressants that are available. Many people take medications like tricyclic antidepressants (TCAs), Wellbutrin (bupropion), or Auvelity (dextromethorphan / bupropion) instead.
TCAs work by increasing activity of serotonin and norepinephrine, but they also affect acetylcholine and histamine. They can cause additional side effects because they affect more neurotransmitters.
Wellbutrin increases the activity of dopamine and norepinephrine without affecting serotonin. As a result, it has a different side effect profile than SSRIs and SNRIs.
Auvelity is a newer antidepressant that works in its own unique way. It affects N-methyl-D-aspartate (NMDA) and sigma-1 receptors. It’s often effective within a week.
Other antidepressants also exist, but they’re not as common. If you have questions about how your Effexor prescription compares to another antidepressant, ask your pharmacist or healthcare provider.
What other treatments can be combined with Effexor for depression?
Not everyone responds to antidepressant medications the same way. If Effexor isn’t working well on its own, you may be told to pair it with something else — or replace it altogether.
Oftentimes, combining Effexor with a non-medication treatment like cognitive behavioral therapy (CBT) is a good place to start. CBT is a type of psychotherapy where you can discuss your mood and thoughts with a therapist. Your therapist is there to listen and offer you guidance and direction.
Medications that work in different ways can also be combined with Effexor for additive effects. This includes treatments like Buspar (buspirone), Abilify (aripiprazole), thyroid hormone, and others.
Is Effexor a long-term solution for depression?
It can be, yes. If you’re tolerating Effexor well and it’s helping manage your symptoms, Effexor is a long-term option for treating depression.
Most antidepressants need several weeks before they start making a meaningful difference. In some cases, it may take several months before you achieve remission, or full relief of depressive symptoms.
If your symptoms do substantially resolve, your healthcare provider will likely want you to continue taking your current Effexor regimen. They may suggest continuing the antidepressant for at least a few months to minimize risk of relapse. Depending on your preferences, you may opt to take it for several years.
The bottom line
Effexor (venlafaxine) is a prescription medication that helps improve serotonin, norepinephrine, and dopamine levels in the brain. This can help improve your mood, but it may take 4 to 8 weeks to take full effect. The usual starting dose of Effexor for depression is 75 mg daily, but your healthcare provider may opt to raise your dose if this starting dose isn’t making a big difference.
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References
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Bryant Ranch Prepack. (2023). Venlafaxine hydrochloride- venlafaxine hydrochloride capsule, extended release [package insert].
Gelenberg, A. J., et al. (2010). Practice guideline for the treatment of patients with major depressive disorder, third edition.
Jaracz, J., et al. (2016). Unexplained painful physical symptoms in patients with major depressive disorder: Prevalence, pathophysiology and management. CNS Drugs.
Liu, X., et al. (2021). Discontinuation of antidepressants: Is there a minimum time on treatment that will reduce relapse risk? Journal of Affective Disorders.
Moraczewski, J., et al. (2023). Tricyclic antidepressants. StatPearls.
Moret, C., et al. (2011). The importance of norepinephrine in depression. Neuropsychiatric Disease and Treatment.
Nutt, D. J. (2008). Relationship of neurotransmitters to the symptoms of major depressive disorder. The Journal of Clinical Psychiatry.
Sheffler, Z. M., et al. (2023). Physiology, neurotransmitters. StatPearls.
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