Please tell me about Effexor.
February 20, 2010 5:25 PM   Subscribe

Please tell me about Effexor.

Yesterday I had finally had enough of my anxiety symptoms and went in to see my doctor. After checking me over and confirming that anxiety seemed to be the cause of my troubles, she prescribed Effexor (75mg). I've never been on this drug before, but I have been on Zoloft, which I have been off for about four years. That drug made me feel better about myself and calmed the anxiety, but I also gained an unhealthy amount of weight and experienced headaches. I wish I had known what I was getting into when I started Zoloft.

So now I am staring at this prescription bottle and I find myself scared. I just don't know if I want to do this all over again. I was never able to shake the weight I gained on Zoloft and am worried about that and what other things this drug might have in store for me. My doctor mentioned possible diarrhea, but stopped there. A quick scan of Wikipedia shows many more side effects.

What has been your experience with this drug? I'd appreciate stories concerning both the good and the bad. I know it will probably be good for me, but before I take that first pill, I just want to know for sure what might and could happen. Thank you!
posted by anonymous to Health & Fitness (43 answers total) 5 users marked this as a favorite
i was on Effexor for about a year and a half. it seemed to help my anxiety, but i went off of it because my psychiatrist wanted to try something else, and because it seemed to make me exhausted and zombie-like.

the worst thing about it, for me, was coming off of it. if you come off of it, please, please, please talk to your doctor about going off of it as slowly as possible. if you go off of it too quickly, you can experience a number of awful side effects. i went off of it much too quickly and it was a very scary experience. also, if you skip a day's dose, you might notice some weird effects, so try not to miss it if you can help it.

for what it's worth, i do know people who have been on it for a few years who are now anxiety-free. so if it works for you, that's great! but if you need to come off of it, be careful.

best of luck.
posted by gursky at 5:31 PM on February 20, 2010 [1 favorite]

Nthing gursky!
posted by jgirl at 5:39 PM on February 20, 2010

Yes, what gursky said. Also, no weight gain because of the Effexor, in my case, or any other unpleasant side-effects for that matter. (In fact, my MD told me it doesn't cause weight gain at all.) However, YMMV, as in all things. All in all, I like my Effexor very much.
posted by MelanieL at 5:47 PM on February 20, 2010

N+1thing gursky. I went off Effexor because it just made me more anxious, and I had horrible side effects- anxiety, shakes, weird electrical sensations, the works. And for the love of God, stay in touch with your doctor while you're taking it. Right now I'm coming off of Pristiq (a closely related drug) after three weeks of treatment took me from tiredness and lethargy to uncontrollable crying and suicidal thoughts.
posted by Merzbau at 5:50 PM on February 20, 2010

*Withdrawal effects, that is.
posted by Merzbau at 5:50 PM on February 20, 2010

It is lovingly referred to as SideEffexor, if that helps. It is excellent if what you need is an anti-depressant with an anti-anxiety sidecar, but it can be difficult to get on (time of day for taking it is important) and difficult to get off if you do not taper. Dry mouth and anorgasmia were routine side effects for me. I also slept an enormous amount as my body adjusted.

Having said that, it has been tremendously effective for me in the past, and it is my go-to drug when things are, you know, heading for destructive and unmanageable. I would consider myself a fan. And you know, hey - unlike Wellbutrin, I have never seen my dead grandfather standing in my kitchen while taking it, so that's a bonus.
posted by DarlingBri at 5:55 PM on February 20, 2010

A coworker of mine started Effexor and immediately complained of anorgasmia/ejaculation disorder. Yay for anecdata!
posted by infinitewindow at 6:02 PM on February 20, 2010

I have found Effexor helpful, after an unsuccessful trial of Wellbutrin. Don't forget to take it. When I do so, I start feeling pretty weird late in the day. I was diagnosed with sleep apnea around the time I started taking Effexor, but I think that's a coincidence. Good luck.
posted by lukemeister at 6:05 PM on February 20, 2010

I've been on it for years, and can confirm everything mentioned above.

Also, note that there are two versions, the normal one and extended release. Both are available now in generic versions (venlafaxine).

If you take the normal version, it gets into and out of your system quickly, so I take it twice a day. When I took the extended release, I took it once in the morning.

I initially switched from extended to normal when my insurance changed and I couldn't afford the extended anymore, and it was not yet available as a generic. But now I haven't switched back because the normal seems to be working fine.

In my case, the doctor had to approve switching from the Effexor brand name to the generic venlafaxine. But the savings are significant so definitely ask your doctor about it.
posted by SuperSquirrel at 6:10 PM on February 20, 2010

Nthing all the comments about withdrawal and tapering should you need to stop. I am not exaggerating here: I had to open the capsules and remove one more grain each day to come off of 75mg, which is a low dose.

As far as side effects, it was benign for me, but antidepressants vary so widely person to person. Lukemeister is right about taking it regularly though, I also had the 2pm "I feel really weird in a vague dizzy/unstable/scatterbrained way - oh, must've forgot the Effexor" experience.
posted by Flannery Culp at 6:17 PM on February 20, 2010 [1 favorite]

If you read the CrazyMeds link above, which I highly recommend you do, it goes into side effects and what not and also explains a little bit of the mechanism of action of Effexor.

Good things: Effexor is, as one of my friends put it, "anti-depressants on turbo." It made me feel better when I thought nothing else was going to. I have never had an antidepressant work as quickly and as dramatically on my anxiety or on my depression as Effexor has.

Bad Things:
* Your blood pressure may go up, as mine did. Make SURE your GP or psychiatrist is watching this and knows what your regular pressure is, as in a few people, it can reach dangerously high levels. Probably not at the dose you're taking, but better safe than sorry.

* If you ever want to stop, for the love of little green apples, taper SLOWLY. This does not mean that you can never stop taking it, just that it's generally going to take as long to taper off as it did to taper up to your current dose (rule of thumb).

* There may be sexual side effects. I've experienced both anorgasmia (inability to reach orgasm, only lasted a few days) and delayed orgasm (permanent, fairly minor for me).
If this is an issue, your doctor, who you NEED to tell about ALL of your side effects, no matter how embarrassing-- may want to add Wellbutrin.
Caveat: Wellbutrin raised my anxiety level, but in the end it was worth it for the effect it had on my residual depression. Since you're not dealing with depression (or at least haven't been diagnosed with it), YMMV.

* Depending on how bad your anxiety is, Effexor alone may not be enough. Some adjuncts that helped me: Buspar (buspirone), or possibly a benzodiazepine such as Valium or Klonopin.
Those two benzos are fairly long acting, whereas Xanax/Ativan are short acting and thus can be more habit forming but all benzos can be very habit forming. They should never be combined with alcohol.
TALK TO YOUR DOCTOR ABOUT THIS if you think you've reached a limit on what the Effexor can do for you and want to add another medication! TALK to your DOCTOR about this. Talk to your doctor about this. Seriously. I cannot stress it enough. And ideally a psychiatrist, NOT your general practitioner! Polypharmacy is serious business and should only be done under the care of an experienced, knowledgeable psychiatrist.


Please don't be scared off by the fact that my list of bad things is much longer than the list of good things. The good things that can come from this medication, for me, have far outweighed any side effects.

Important note: This is not a thoroughly researched and extensive list of pros and cons, this is just off the top of my head. IANAD; my only reference is my own experience and education. I have been on Effexor or Pristiq (Effexor's active metabolite, to get around patent ending probably, but it doesn't raise my blood pressure like Effexor did) for 3 years now. I have also been on all of the drugs that I mentioned above as possible adjuncts, with the exception of Xanax. I have had quite a few diagnoses*, but my current ones are Major Depressive Disorder, Generalized Anxiety Disorder and Panic Disorder.

*never bipolar/schizophrenia but if I ever get those I'll complete my own personal game of DSM Axis I Bingo
posted by saveyoursanity at 6:23 PM on February 20, 2010

Oh, and feel free to MeMail me if you like.,
posted by saveyoursanity at 6:27 PM on February 20, 2010

Effexor has been the only drug that works for me. Apparently Effexor is good for controlling anxiety and depression as well as curbing OCD (thoughts in my case, rather than rituals). I had all of those so to me it was a godsend. It's also the only anti-depressant that didn't turn me into a zombie.

I wound up losing weight on the drug initially, but then balanced out to my usual weight. There was a sexual side effect (not able to orgasm - woo!) which was the same as with the other anti-depressants I had taken. But that went away after a month. I noticed that I sweated more on this drug when I first began it. I don't know why that was. Not in my daily life, but at the gym. I found that strange but not a big deal.

I still take it now, years later and one long-term thing to keep in mind is your blood pressure levels. Apparently Effexor can cause elevated blood pressure. Maybe it was the cause of all the sweating at the beginning. Anyway my blood pressure has remained normal.

There are certain homeopathic things you shouldn't take with Effexor. Valerian root is one - check with your shrink about others. Most cold medicines are fine, however. It's easier to take other drugs with Effexor than it is with most other antidepressants.

Getting off of it should be taken seriously. No going cold turkey. You won't die or anything if you do, but it's not a good idea. You must taper off of it. If you do it slowly, it's not a big deal. Also, keep in mind you can't skip pills, run out of your prescription and not get it refilled, etc. One day without the medicine can make you feel icky. Dizzy. Like electric shocks are going through your body.

And, as always, I speak here not as a doctor but as a Medicated-American.
posted by Kloryne at 6:33 PM on February 20, 2010 [1 favorite]

I sure wish I could email a throwaway account for this one, because I'm afraid this might be a bit of a derail, but when you say you saw "your doctor" and she prescribed Effexor, do you mean your general practitioner? I wonder if you might be feeling more secure about taking the drug if it were under the guidance of a psychiatrist, being a more specialized doctor who sees more patients for anxiety and might be better able to talk to you about side effects. Or even if you were to talk to a psychologist, who is unable to prescribe meds herself but could have a psychiatrist who prescribes meds.
posted by palliser at 6:36 PM on February 20, 2010

Bottom line here is that different drugs have widely variant effects on different people, but the withdrawal issue definitely seems to be more severe with effexor than with others. As a result, like palliser says, you might want to be sure you are being seen by a specialist (even more specialized than psychiatrist is psychopharmacologist: drug specialist psychiatrist) so that the choice of med is based on some kind of knowledge, rather than just "this is drug I happen to have experience prescribing" or worse, "this was latest drug rep to visit me." (latter usually not a conscious influence of course).
posted by Maias at 6:48 PM on February 20, 2010

FWIW, I've been on many different meds for my depression over the last 20 years. (Elavil, Prozac, Wellbutrin, an MAOI, etc.). Currently on Zoloft and love it, even with the weight gain thing (it's evened out for me after three years). When I was on Effexor in the late 90's-early 00's, it worked relatively well for 3 years. And then it stopped working. Full stop.

I was tapered off of it a full year before Pfizer finally acknowledged that there WERE withdrawal problems with Effexor for some patients. I experienced the "brain zaps", the splitting headaches, weakness down one side of my body, small seizures. I was reversing words in sentences and couldn't process auditory information very well. My heart rate was all over the place. My body craved carbs to soothe itself and help induce sleep. So, any advantages from the Effexor in the weight gain department were lost during withdrawal. It was hell. Really hell. And especially hellish since we thought I had something unidentifiable while Pfizer was sitting on all of the feedback they were getting from patients about withdrawal and not sharing it. To be very frank with you, I felt it took a few years to recover from the effects of the Effexor withdrawal, physically/cognitively/emotionally.

On the other hand, everyone's physiology is different. Your experience on Effexor may/may not be my experience. Your eventual withdrawal may/may not be similar to mine. I think the important things to ask yourself are:

1) Am I seeing a psychiatrist that I absolutely trust? (Don't let a general practitioner prescribe antidepressants to you. Really.)
2) Do I have a pretty good support network? A spouse? Really reliable, understanding roommate?
3) Did my depression respond well to anything else (putting aside inconvenient but tolerable side effects)? If I went back on that med and adjusted my lifestyle to compensate for things like weight gain, would that be a suitable alternative?
4) Have I exhausted all other options? Is the potential reward of Effexor at this point greater than the potential risks experienced if it doesn't work and I have to go through withdrawal?

If you have a good psych meds doc, he/she will walk through these questions patiently with you and give you options. Not just say, "Here, take this. Call me in six weeks. Don't ask questions."

Take good care of yourself, and I'm hoping you feel better soon.
posted by jeanmari at 7:16 PM on February 20, 2010

I was on Effexor for a brief period last year; my therapist recommended it b'c of my weight and the lack of weight gain side effects associated with Effexor. The only side effect I had with it was anorgasmia, which made me reject the drug within a few weeks.

I've been on Pristiq ever since with good results (although, having now read some of the forums on that CrazyMeds site, I'm wondering if my occasional inability to find the correct word and if my nightly "restless legs" are caused by the Pristiq).
posted by LOLAttorney2009 at 7:33 PM on February 20, 2010

Experiences vary so much. It is a good thing to keep in mind, really keep in mind, that you are taking medication that can have side effects and can affect your mood. So if you find yourself reacting well, that's good, but if you find yourself not reacting well, feeling more down or anxious or whatever, keep in mind that you are taking medication that affects your mood, and it is the medication.

I took it some years ago and it wasn't good at all for me. Had the opposite of the intended effect, to be honest, plus.. most people probably don't think it's fun to feel like tiny electric shocks are being administered to your brain. It wasn't funny at the time, at least. But I knew in the back of my mind (thank god) that it was the Effexor, and that the terrible mood I was in while taking it would go away once I tapered off and stopped. So I tried to go easy on myself if I couldn't get much done while waiting for the Effexor to wear off, which I could not. But long term there was no harm done, except a few weeks of not cleaning my apartment much and turning in homework late, that's all.

It just seems to be trial and error with many of these drugs, and can't be helped. And if you do care to try and lose the weight, I can tell you that it can be done, having put on a good 30 pounds with Prozac. I gradually lost it over the course of 5 years after I stopped, without really trying hard: smaller portions, more protein and less carbs, water and herbal tea instead of juice/soda, walking a lot more.. nothing drastic, I eat what I want now and never gain weight. Could've lost it faster if I'd really tried hard, but the small changes plus no Prozac worked out well for me. Although.. I can hardly say the anxiety is gone. I try to not blame myself for it. I might have a lot less if our modern world wasn't so damned difficult to live in.
posted by citron at 7:41 PM on February 20, 2010

Mod note: This is a followup from the asker.
Throwaway email address created: Thanks for the answers so far! It's certainly making me think. The Effexor was prescribed by my general physician and I forgot to mention that it will be 75mg twice a day. I haven't started taking it yet and it's been two days since I got the prescription filled. I'm just hesitant. Things aren't so bad that I couldn't go another week or so without drugs...I'd rather have that than to get on a drug that may not be right for me but takes a long time to taper off of. I will look into seeing a psychiatrist and probably therapy as well. Thanks!
posted by cortex (staff) at 7:46 PM on February 20, 2010 [1 favorite]

Thank you for the update! I don't know all that much about this stuff, but I'm sort of blinking at the fact that a GP prescribed Effexor for anxiety that had responded to Zoloft in the past, and when you asked about side effects, said, "Diarrhea." Huh.

Yeah, a shrink of some sort seems in order here.
posted by palliser at 7:59 PM on February 20, 2010

I take 75mg once a day -- I'm pretty sure it's the XR. It works wonderfully. I noticed this especially when I switched to Celexa and went completely bonkers :P

The thing about tapering, though, is that when I wanted to switch from Effexor to Celexa (mainly because I'd heard of the side effects and thought, "Hey, maybe I can get decent results with fewer side effects on something else"), my psychiatrist said I'd be fine as long as I had SOMETHING in my system, so... hmm, I can't remember if I had to go down to half dose before going to Celexa, but it was only a week or so. The crazies came fully a month or two later, and I switched back to Effexor immediately with no problems.

I don't have any side effects that I can tell. However, if I forget to take it for a day, or even forget until after lunch, I get the "zaps" -- which aren't actually horrible, just a slightly unsettling reminder that I didn't do what I was supposed to do.

I'm a little worried about tapering down/going off for a potential pregnancy in the future, but this is a reasonably low dose.

I haven't had any problems whatsoever with my sex life. In fact, being a happier me probably means I get some more often. Awwwww yeeeeeeah!
posted by Madamina at 8:10 PM on February 20, 2010 [1 favorite]

I have never, EVER, had those "electrical" effects others are describing here, with effexor. (That sounds horrifying!) However, I use the XR, and when I'm absentminded (it occurs fairly frequently) and forget my pill in the am, I feel really awful by the middle of the afternoon - headaches, dizziness, sort of like being motion sick.

As for weight gain, I had that with zoloft and it sucked. Before zoloft, many years ago, I never snacked, I ate reasonable amounts, and just didn't have an interest in anything else. While taking zoloft, I could just eat and eat and eat. With effexor, it's the same as with zoloft, but I can't tell if it's left over from the zoloft, a new side effect from the effexor, or just because of other personal issues.

Oh! And with effexor, I'm totally cheery most of the time, without feeling like I'm acting fake/weird/not like myself. Anxiety is also way down.
posted by violetish at 8:44 PM on February 20, 2010

I've been helped by Effexor XR twice (used regular Effexor for a while, too, but that was side effect circus, so I was moved onto XR).

Side effects weren't so bad for me when on...a bit of tummy trouble during the adjustment phases, needing to drink more water, but that's about it. I lost weight due to being able to pay attention to my schedule and metabolic demands. It did help me quit feeling crisis-ridden, even though I was (i.e., individual problems seemed more solvable instead of a giant, evil forest). It did help tone down the anxiety, but I still needed an additional medicine to help relieve the feelings of terror.

Both times, I had to stop taking suddenly with no tapering down. I didn't have quite the experience others have described. Some of the electricity thing, but that was about it. It didn't kill me. Maybe due to being focused on other things? Not sure.

As others have stated above, it's such an individual experience, so subjective, it's hard to quantify someone else's reactions to how it'll effect you. I know it feels better to see that others tried it and made or to at least know what the risks are.

I'm glad you're considering moving your meds management to a psychiatrist - they have more up-to-date knowledge of the current chemical therapies (or should). And since they can't help with the internal stuff, a therapist is the best side prescription you can add to any medication cocktail for mental/emotional issues. Again with subjective information, but therapists who practice Cognitive Behavioural Therapy are supremely helpful for those with depression and anxiety. You get the support you need AND coping skills that will help you for the rest of your life.

Fortitude & luck!
posted by batmonkey at 9:35 PM on February 20, 2010

I love it. Absolutely love it. YMMV, IAMA (I am not anything), etc.

I've been on it for five months now. After a month and a half they boosted the dose (a very low initial dose) to about what you have been prescribed. Side effect speaking, the first month or so I had dry mouth. I'm on the XR and it makes me a little queasy, so I take it right before bed. If I forget to take it, I start to get withdrawal effects the next evening (mainly brain shivers). I haven't experienced any sexual side effects.

Regardless of the side effects, you can pry my prescription bottle out of my cold, dead hands. It has dramatically improved my life for the better. I feel like a new person. I'm able to focus. I've started eating better, working better, dedicating myself to my school work, and keeping the house in shape. I no longer feel the urge to curl into bed as soon as I get home. I can concentrate, I have better self-control and I take better care of myself. Again, uh, YMMV, IAMA.
posted by lizjohn at 10:08 PM on February 20, 2010

No one can tell you if Effexor is right for you, or if it will help you, but I can say that it did help me a bit, but I was on it for about 3 years unwillingly.

The psychiatrist that initially prescribed it to me left the practice, and none of the other doctors were willing to help me taper it off safely. I'd read up on the potential withdrawal effects beforehand and they terrified me. For reference' sake, I once took a dose about 6 hours late and turned into an angry, anxiety-ridden mess.

I gained about 35 pounds. No sexual side effects.

Even when I decided to taper off very slowly on my own, I still felt some major withdrawal effects, and I did it over the course of about 2 months.

I do regret taking it.
posted by rachaelfaith at 10:34 PM on February 20, 2010

Three things:

1) If you don't take your effexor you will have trouble sleeping

2) If you try to stop taking your effexor, the withdrawl includes flu-like symptoms

3) Effexor is an SNRI (serotonin norepinephrine reuptake inhibitor) whereas sertraline is an SSRI (selective serotonin reuptake inhibitor), expect more stimulation with effexor.
posted by candasartan at 10:37 PM on February 20, 2010

Oh yes and really really important: TAKE EFFEXOR in the MORNING! I knew someone who took it at night for years and suffered with trouble sleeping and tiredness all day for many years because they didn't follow this simple direction.
posted by candasartan at 10:38 PM on February 20, 2010

Effexor is the only one that works for me (have also tried Wellbutrin, Elavil, Zoloft, and Paxil before). Contrary to candasartan's statement, Effexor makes me tired, and I just switched to taking it at night and am no longer sleepy during the day.

Be cautioned that there really aren't many SNRIs out there (this is what my doctor said to me about 2-3 months ago), especially compared to SSRIs. If you find SNRIs work better for you than SSRIs, but you need to switch for some reason, there aren't a lot of other options. That is definitely not a reason not to try Effexor though.

Pristiq (desvenlafaxine) is a derivative of Effexor (venlafaxine) and Wyeth/Pfizer's new grab at patented high-priced brand name medications, since venlafaxine has gone generic. "They" (your doctor, pharmacist, insurance company, etc.) may try to tell you that Pristiq is virtually the same thing as Effexor. This is not necessarily true - I tried Pristiq for a year and was having much more severe symptoms, both in terms of depression and anxiety. Effexor just works better for me.

Also if they try to get you to switch to Pristiq, be aware that it was one of the few drugs tested in which increasing the dose did not increase the efficacy of the drug. The regular dose is 50mg and increasing to 100mg made no difference in the blind trial tests. My doctor was willing to try the increase anyways, but like I said, Pristiq didn't work for me. With Effexor, you have plenty of room to increase your dose if you need to. I happily settled at 150mg with adequate relief.
posted by IndigoRain at 11:45 PM on February 20, 2010

I was on Fluoxetine ( generic prozac, an SSRI) for 4 months for moderate-to-severe work-replated major depression but found that it wasn't working well for me, even with increasing the dose to maximum. I switched over to 75mg venlafaxine XL, the generic of Effexor XR (once a day in the morning) 4 weeks ago, and so far I've found it a much better drug. 75 mg daily is a low dose; 150mg is 'average' and some doctors will prescribe up to 350mg daily.

The difference between me now and where I was 4 weeks ago is a very marked improvement; I feel like a normal human being for the first time in years. My mood has massively improved, and problems that seemed completely insurmountable before are now finally becoming manageable, even trivial. I'm no longer ashamed or guilty over what felt like a self-inflicted failure, but now accept it's a treatable disease like any other. I find my self-confidence is returning, and I'm even able to be more assertive.

Before, I was hanging onto functioning by my fingernails and sheer force of will. Now, I'm starting to actually enjoy life for the first time in so long I can't remember. As always, psychopharmacology is a complex subject that varies heavily from person to person, and obviously keeping in constant contact with your doctor, ideally a specialist, is a must as everyone has different reactions and anecdote is not data.

I'm also working with a therapist, and will be starting CBT therapy soon now I'm in a fit state to work longer term on managing my mental state with the goal of eventually coming off the effexor (possibly in 6 months time or so).

There are some side effects. Dry mouth is a common one, and one I'm getting; it's similar to that feeling you get when you haven't had a drink for a while. It just prompts me to drink more water, which isn't a bad thing and is pretty minor. I am also having anorgasmia, though desire has returned which it didn't on prozac and I can life with it for now.

Suicidal thoughts are an issue with anti-depressants (and depression), and a UK study did show a slightly higher correlation with completed suicides on venlafaxine, though it is used as a 2nd line anti-depressant for severe cases so it's not considered to be statistically worse. If you do have any feelings in that direction, do talk to your medical professionals immediately.

I have yet to miss a day on the drug, though I was warned that as it tapers off quickly the effects can be quite noticeable, especially so on effexor rather than the extended release version I'm on, so something to be wary of. The discontinuation syndrome for effexor is also very common, so coming off is a slow and careful process, not least as a sudden stop can lead to much greater suicidal thoughts in additional to the physical discomfort - I was very explicitly warned repeatedly not to stop taking it without supervision. One common method to 'wean you off' effexor is to switch you to fluoxetine, and then taper that off, as it's a much easier discontinuation than effexor directly - most people taper off prozac with few to no side effects.

All in all though; it's a great drug that's drastically improved my mental state and given me the breathing room to work on my issues and put together my longer term plans without being overwhelmed by anxiety, disastrous thinking and worry-stress. It works for me, anyway.
posted by ArkhanJG at 1:27 AM on February 21, 2010

Regarding antidepressants and anorgasmia - I'm on Celexa, and when I first went on it, I found it much, much more difficult to reach orgasm. However, after a while (maybe 3 months?) that side effect gradually became less noticeable. I've now been on Celexa for about 2 years, and it's either not harder at all or perhaps marginally harder to reach orgasm, and it's really not a problem at all.

So, anecdotally, anorgasmia can lessen with time. I've also heard this from friends. For me, it was worth tolerating a few months of anorgasmia - my depression was very severe, Celexa helped a lot, I was single.
posted by insectosaurus at 7:53 AM on February 21, 2010

Yeah, nthing the withdrawl side effects. My sister was on it for a while (actually for migraines), and decided to get off of it because of her weight gain (probably 30 pounds). Coming off of Effexor was horrible for her, and she is very wary of all prescription meds now.
The doctor never told my sister about these side effects; I am on generic Prozac and my psychiatrist didn't tell me about the side effects associated with that either. I would encourage everyone to seriously require their doctor, if they are not forthcoming, to explain side effects of ALL medicines. Take research back, and talk to your doctor about what you learned. You have every right to know what a medicine she gives you will do to your body, and she needs to be able to have a sufficiently detailed conversation about it.
I get riled up about this stuff; poor client service doesn't fly in any other sector, and it especially shouldn't in medicine.
posted by afton at 8:04 AM on February 21, 2010

Everyone reacts to medication differently.

Me, I LOVED Effexor--and I am incredibly sensitive to these sorts of pills. (I don't generally take anything stronger than Advil. I nearly lost my mind after 72 hours on Wellbutrin, because I had a big cup of coffee and those two things DO NOT MIX for me. Yow. Bad times!)

My personal experience suggests that you should have someone very involved in monitoring dosage. But more importantly. If you are sick of your anxiety symptoms, as you should be, Effexor is what you go on while you DEAL WITH the underlying reasons for anxiety. This medication is something that will assist you while you are getting ACTUAL treatment. (REITERATING: all of this is my experience only!) Effexor is not that treatment! The goal of a real treatment is not to put you on drugs for the rest of your life. If you could see a cognitive behavioral specialist, for perhaps 8 to 12 weeks, who also has experience with medication management, that would be ideal (IN MY EXPERIENCE!)

You do not need to be in treatment for the rest of your life. The good news is that you can get patched up, if you commit to doing some serious work about root causes and conditions, and get back in the game, anxiety-free. (And I say this as someone who used to walk up fifteen flights of stairs because he wouldn't get in elevators. Ha, I can't even imagine believing such a thing now! Elevators!)

That being said, I wish a little that I was back on Effexor right now. It made me incredibly focused and filled me with a strong sense of efficiency! I slept like five hours a night and sprang out of bed and boy was I ever getting things done! And I started at an even lower dose than you, and moved up, I think, to your level. (I had a friend however who was prescribed at about 4 times your dose, because his symptoms were... let's say significant! Um, he saw, like, halos and colors around everything and was basically licking light switches and stuff in an OCD manic fit.)

Still, treatment + medication helped me overcome my anxiety symptoms almost entirely and I do still remain graduated from treatment, so, yay. Best of luck to you.
posted by RJ Reynolds at 8:49 AM on February 21, 2010 [1 favorite]

Effexor XR taker here as well and nthing all the withdrawal issues. I'm pretty diligent about taking it regularly but if I get 2 or 3 days off it (for whatever reason), I start feeling all barfy and nauseous. Just generally icky. Pay attention to all the words of warning on this issue.

My highest dosage was 150mg. I was worried about weight gain and my doc said that above 150mg, that was more of a possibility. Right now I'm on 75mg and seem to be managing well.

I've also taken prozac until it crapped out on me, celexa and a couple others. So far, effexor has worked well for me. Also agree with the other comments about working with a psychiatrist who is well versed in all the intricacies of dosing and effects.

Good luck! It's totally trial and error until you find what works for you. If you start feeling wonky, FOR ANY REASON, consult your doc asap.
posted by Mysticalchick at 8:51 AM on February 21, 2010

I nth all of the issues with withdrawal; I had to take anti-nausea medicine even while slowly tapering off. Also, I experienced an odd side effect: I had a sudden weight gain AFTER I stopped taking the medicine. It wasn't a normal weight gain, either; I was horrifically bloated for about two months (like, distended-stomach bloated), and could do nothing to remedy it. It was very odd and upsetting, although it did subside after about three months.
posted by sarahsynonymous at 10:46 AM on February 21, 2010

All responses have been excellent, chiming in to reiterate that the 'coming off' or 'withdrawal' symptoms are horrible. I too had a psychiatrist that was 'testing' different medicines for me to try and had my try 37.5 MG of Effexor XR for about three months, coming off such a small does too nearly a year as it was week on take week off not take, at first the 'shocks' and 'chills' of the withdraw were awful, at one point I was in the ER on a Sunday afternoon because of vertigo and shivering.

Unless your psych/doctor is absolutely sure Effexor is the only you can take I would seriously look at other meds unless you can be tied to this one for a long long time.
posted by dolemite01 at 12:18 PM on February 21, 2010

Effexor messed me up, but it sounds like some other people have had good luck with it. It's super important to remember that it's going to be different with everyone, I suppose.

I had headaches every day, I woke up pretty much every hour at night, and I felt like I could eat nothing but tacos. Yup. Effexor caused me to crave tacos. The nice thing was that I actually lost weight (kind of rapidly) while one it and eating all of these tacos. However, the not sleeping well thing combined with the fact that it didn't start helping in about a month made me go back to Lexapro. I didn't have any problems when I stopped taking it and the side effects disappeared almost instantly for me. Its so weird how differently it affects people...
posted by couchtater at 1:46 PM on February 21, 2010

Effexor also messed me up. Before I was on it, I was just generally depressed and irritable. Once I was on it, I started having vivid dreams about suicide and began contemplating it more seriously than I ever wanted to, but it obviously has different effects for different people.
posted by june made him a gemini at 6:39 PM on February 21, 2010

While I agree that it is very important that you taper off of Effexor, I just want to say that it isn't necessarily a horrible experience for everyone. I was on Effexor several years ago at an very high dose (I think it was total of 300- 350 mg/day, it was higher than the highest single dose available) under the supervision of a psychiatrist for a clinical trial. Ultimately Effexor worked for me to a certain extent, but I reached a plateau, and never got better. He decided to try something else, So I tapered down, under his supervision, and I don't remember it taking an inordinate amount of time. I simply went down to the next lowest dosage each week or so until I got to 37.5 mg. After that I broke open the capsules and stirred half into a glass of juice (on the suggestion of my Dr.). Having heard what a nightmare it was to get off of Effexor, I was pleasantly surprised that in the end I only suffered through a day or so of feeling a bit dizzy when I first switched to the lowest doses. So yes, people have awful experiences coming off of Effexor. I don't doubt their stories, although I think some of them weren't told about halfing the 37.5 mg. capsules and tried to go cold turkey from that dose (my sister's doctor hadn't mentioned it to her as one case that I know about). But my point is, that this might not be your experience. I have to say that for me it pretty much was a cake walk, or at the very least a non-event.

Also while I was on Effexor, and most other anti-depressants that I'd tired, the main side effect for me was insomnia. It settled down a bit, but I always felt that it took me longer to get to sleep than when I wasn't on anything.
posted by kaybdc at 8:43 PM on February 21, 2010

Oh, one other side effect for me with Effexor at the beginning. Very, very weird and vivid dreams. I have always had strange dreams but these were really creative ones. Not scary but just wacky. Also, when I woke up first thing in the morning I would have tracers in my vision for about a half hour.
posted by Kloryne at 1:28 PM on February 22, 2010

i have taken effexor twice now, i believe. i have also been on paxil, celexa, and zoloft. effexor was the only one that didn't give me noticeable side effects. i did have some sexual side effects, but i didn't even recognize those until i was off the meds.

it did do wonderful things for me and was the only one that helped me when i thought nothing could. lots of the other meds i tried made me feel "crazy" and out of it. effexor took the edge off and made me able to participate in life. i did have to up the dose at least once because i hit a wall with it, but other than that...

if you need something, don't be afraid to try it. it worked so wonderfully for both my anxiety and my depression. i know several people that this has been a miracle for, so maybe it will be for you too. just be vigilant about side effects and give it time to work. some of the side effects can go away after time, so be aware of that also.

i was terrified to go off of the effexor and did have some trouble, but didn't experience the brain zaps or anything like when i went off the celexa. everyone is different, so take everyone's advice and experience with some grain of salt.
posted by itsacover at 4:28 PM on February 22, 2010

I was on Effexor XR for about a year and a half. I think at the end it was 125 mgs a day. While I would certainly take the sheer amount of comments here into account, my own experience with stopping the medication was very much the opposite of the stories here.

I just stopped. Which is completely ill-advised, of course, but no one had told me about any withdrawal symptoms so I didn't really think about it. No withdrawal effects whatsoever. I guess I'm lucky.

I did get some headaches when I started, and definitely had dry mouth at the beginning as well, for what it's worth.
posted by aclevername at 7:08 PM on February 22, 2010

june made him a gemini: Effexor also messed me up. Before I was on it, I was just generally depressed and irritable. Once I was on it, I started having vivid dreams about suicide and began contemplating it more seriously than I ever wanted to, but it obviously has different effects for different people.

While the vivid dreams are a (generally pretty awesome, IMHO) side effect of Effexor, the suicidal ideation is a common risk with all anti-depressants. I believe that statistically, patients are at highest risk of suicide immediately after they begin drug treatment. That's because killing yourself actually requires quite a lot of motivation, which people generally lack when severely depressed. You start taking the drugs, you feel more energetic, and suddenly what seemed like too much work four weeks ago seems much more do-able now.

NOTE: Do not do.
posted by DarlingBri at 10:05 PM on February 22, 2010

It was 2004 when I finally started on anti-depressants. First drug was Celexa, it didn't do a thing for me. Next was Effexor and I've been on it ever since. I started out at 75mg once a day and now take 150mg once a day. I've had Wellbutrin added to Effexor, but not for long as it didn't help as I had hoped (sexual side effects). Other than that Effexor worked fine until sometime mid-year 2009 (suicide ideation hit big time). My doc added 25mg of Seroquel in November. Almost immediately I was much better, better than Effexor alone had been. However, I think it may be time to up the Seroquel dose or revisit the whole thing.

As for side effects, I get dizzy by mid-day if I miss a dose. I also have delayed orgasms. I haven't noticed any weight gain or loss. I sleep a lot, both Effexor and Seroquel can cause sleepiness as does one of the drugs I take for diabetes.
posted by deborah at 12:06 AM on February 23, 2010

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