Venlafaxine hydrochloride is a structurally novel antidepressant for oral administration. It is chemically unrelated to tricyclic, tetracyclic, or other available antidepressant agents. It is designated (R/S)-1-[2-(dimethylamino)-1-(4 methoxyphenyl)ethyl] cyclohexanol hydrochloride or (±)-1-[a [(dimethylamino)methyl] p-methoxybenzyl] cyclohexanol hydrochloride and has the empirical formula of C17H27NO2 HCl. Its molecular weight is 313.87.

Venlafaxine hydrochloride is a white to off-white crystalline solid with a solubility of 572 mg/ml in water (adjusted to ionic strength of 0.2 M with sodium chloride). Its octanol:water (0.2 M sodium chloride) partition coefficient is 0.43.

Effexor: Compressed tablets contain venlafaxine hydrochloride equivalent to 25 mg, 37.5 mg, 50 mg, 75 mg, or 100 mg venlafaxine. Inactive ingredients consist of cellulose, iron oxides, lactose, magnesium stearate, and sodium starch glycolate.

Effexor XR: Effexor XR is formulated as an extended release capsule for once-a-day oral administration. drug release is controlled by diffusion through the coating membrane on the spheroids and is not pH dependent. Capsules contain venlafaxine hydrochloride equivalent to 37.5 mg, 75 mg, or 150 mg venlafaxine. Inactive ingredients consist of cellulose, ethylcellulose, gelatin, hydroxypropyl methylcellulose, iron oxide, and titanium dioxide.


INDICATIONS

Venlafaxine hydrochloride is indicated for the treatment of depression. Venlafaxine HCl extended-release is indicated for depression and Generalized Anxiety Disorder.


WARNINGS

Potential for Interaction with Monoamine Oxidase Inhibitors

Adverse reactions, some of which were serious, have been reported in patients who have recently been discontinued from a monoamine oxidase inhibitor (MAOI) and started on venlafaxine HCl, or who have recently had venlafaxine HCl therapy discontinued prior to initiation of an MAOI. These reactions have included tremor, myoclonus, diaphoresis, nausea, vomiting, flushing, dizziness, hyperthermia with features resembling neuroleptic malignant syndrome, seizures, and death. In patients receiving antidepressants with pharmacological properties similar to venlafaxine in combination with a MAOI, there have also been reports of serious, sometimes fatal, reactions. For a selective serotonin reuptake inhibitor, these reactions have included hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma. Some cases presented with features resembling neuroleptic malignant syndrome. Severe hyperthermia and seizures, sometimes fatal, have been reported in association with the combined use of tricyclic antidepressants and MAOIs. These reactions have also been reported in patients who have recently discontinued these drugs and have been started on an MAOI. The effects of combined use of venlafaxine and MAOIs have not been evaluated in humans or animals. Therefore, it is recommended that venlafaxine HCl not be used in combination with an MAOI, or within at least 14 days of discontinuing treatment with an MAOI. Based on the half-life of venlafaxine HCl, at least 7 days should be allowed after stopping venlafaxine HCl before starting an MAOI.

Sustained Hypertension

Immediate Release Tablets: Venlafaxine treatment is associated with sustained increases in blood pressure. (1) In a premarketing study comparing three fixed doses of venlafaxine (75, 225, and 375 mg/day) and placebo, a mean increase in supine diastolic blood pressure (SDBP) of 7.2 mm Hg was seen in the 375 mg/day group at week 6 compared to essentially no changes in the 75 and 225 mg/day groups and a mean decrease in SDBP of 2.2 mm Hg in the placebo group. (2) An analysis for patients meeting criteria for sustained hypertension (defined as treatment-emergent SDBP ³ 90 mm Hg and ³ 10 mm Hg above baseline for 3 consecutive visits) revealed a dose-dependent increase in the incidence of sustained hypertension for venlafaxine.

An analysis of the patients with sustained hypertension and the 19 venlafaxine patients who were discontinued from treatment because of hypertension (<1% of total venlafaxine treated group) revealed that most of the blood pressure increases were in a modest range (10-15 mm Hg, SDBP).

Nevertheless, sustained increases of this magnitude could have adverse consequences. Therefore, it is recommended that patients receiving venlafaxine have regular monitoring of blood pressure. For patients who experience a sustained increase in blood pressure while receiving venlafaxine, either dose reduction or discontinuation should be considered.

Extended Release Tablets: Venlafaxine is associated with sustained increases in blood pressure in some patients. Among patients treated with 75-375 mg per day of venlafaxine HCl (extended release) in premarketing studies, 3% (19/705) experienced sustained hypertension [defined as treatment-emergent supine diastolic blood pressure (SDBP) ³90 mm Hg and ³10 mm Hg above baseline for 3 consecutive on-therapy visits]. Experience with the immediate-release venlafaxine showed that sustained hypertension was dose-related, increasing from 3-7% at 100-300 mg per day to 13% at doses above 300 mg per day. An insufficient number of patients received mean doses of venlafaxine HCl (extended release) > 300 mg/day to fully evaluate the incidence of sustained blood pressure at these higher doses.

In placebo-controlled premarketing depression studies with venlafaxine HCl (extended release) 75-225 mg/day, a final on-drug mean increase in supine diastolic blood pressure (SDBP) of 1.2 mm Hg was observed for extended release venlafaxine HCl-treated patients compared with a mean decrease of 0.2 mm Hg for placebo-treated patients.

In premarketing depression studies, 0.7% (5/705) of the extended release venlafaxine HCl-treated patients discontinued treatment because of elevated blood pressure. Among these patients, most of the blood pressure increases were in a modest range (12-16 mm Hg, SDBP).

Sustained increases of SDBP could have adverse consequences. Therefore, it is recommended that patients receiving venlafaxine HCl (extended release) have regular monitoring of blood pressure. For patients who experience a sustained increase in blood pressure while receiving venlafaxine, either dose reduction or discontinuation should be considered.


PRECAUTIONS

General

Insomnia and Nervousness

Immediate Release Tablets: Treatment-emergent anxiety, nervousness, and insomnia were more commonly reported for venlafaxine-treated patients compared to placebo-treated patients in a pooled analysis of short-term, double-blind, placebo-controlled depression studies.

Anxiety, nervousness, and insomnia led to drug discontinuation in 2%, 2%, and 3%, respectively, of the patients treated with venlafaxine in the phase 2-3 depression studies.

Extended Release Capsules: Treatment-emergent insomnia and nervousness were more commonly reported for patients treated with venlafaxine hydrochloride extended release capsules than with placebo in a pooled analysis of short-term depression studies.

Insomnia and nervousness each led to drug discontinuation in 0.9% of the patients treated with venlafaxine HCl (extended release) in Phase 3 studies.

In Phase 3 GAD trials, insomnia and nervousness led to drug discontinuation in 5% and 3%, respectively, of the patients treated with venlafaxine HCl extended-release.

Changes in Appetite and Weight

Treatment-emergent anorexia was more commonly reported for venlafaxine-treated (11% tablets/ 8% extended-release) than placebo treated patients (2% tablets/ 4% extended-release) in the pool of short-term, double-blind, placebo-controlled depression studies. A dose-dependent weight loss was often noted in patients treated with venlafaxine for several weeks. Significant weight loss, especially in underweight depressed patients, may be an undesirable result of venlafaxine treatment. A loss of 5% or more of body weight occurred in 6% (7% extended-release) of patients treated with venlafaxine compared with 1% (2% extended-release) of patients treated with placebo and 3% of patients treated with another antidepressant. However, discontinuation for weight loss associated with venlafaxine tablets was uncommon (0.1% of venlafaxine-treated patients in the phase 2-3 depression trials). Discontinuation rates for anorexia and weight loss associated with venlafaxine HCl (extended release) were low (1.0% and 0.1%, respectively, of extended release venlafaxine HCl-treated patients in Phase 3 studies).

In the pool of short-term GAD studies, treatment-emergent anorexia was reported in 13% and 2% of patients receiving venlafaxine HCl extended-release and placebo, respectively. A loss of 7% or more of body weight occurred in 3% of the venlafaxine HCl extended-release-treated and 0% of the placebo-treated patients in these trials. Discontinuation rates for anorexia and weight loss were low (1.7% and 0.2% respectively, of venlafaxine HCl extended-release-treated patients).

Activation of Mania/Hypomania

During premarketing depression studies, mania or hypomania occurred in 0.3% of extended-release venlafaxine HCl-treated patients compared with 0.0% of placebo patients. In premarketing GAD studies, 0.0% of venlafaxine HCl extended-release patients and 0.5% of placebo-treated patients experienced mania or hypomania. In all premarketing depression trials with venlafaxine HCl, mania or hypomania occurred in 0.5% of venlafaxine-treated patients compared with 0% of placebo patients. Mania/hypomania has also been reported in a small proportion of patients with mood disorders who were treated with other marketed antidepressants. As with all antidepressants, venlafaxine HCl extended-release should be used cautiously in patients with a history of mania.

Seizures

During premarketing experience, no seizures occurred among 705 extended-release venlafaxine HCl-treated patients in the depression studies or among 476 venlafaxine HCl extended-release-treated patients in GAD studies. In all premarketing depression trials with venlafaxine HCl, seizures were reported at various doses in 0.3% (8/3082) of venlafaxine-treated patients. Venlafaxine HCl, like other antidepressants, should be used cautionsly in patients with a history of seizures and should be discontinued in any patient who develops seizures.

Suicide

The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs. Close supervision of high-risk patients should accompany initial drug therapy. Prescriptions for venlafaxine HCl should be written for the smallest quantity of tablets or capsules consistent with good patient management in order to reduce the risk of overdose. The same precautions observed when treating patients with depression should be observed when treating patients with GAD.

Use in Patients with Concomitant Illness

Clinical experience with venlafaxine HCl in patients with concomitant systemic illness is limited. Caution is advised in administering venlafaxine HCl to patients with diseases or conditions that could affect hemodynamic responses or metabolism.

In patients with renal impairment (GFR=10-70 ml/min) or cirrhosis of the liver, the clearances of venlafaxine and its active metabolite were decreased, thus prolonging the elimination half-lives of these substances. A lower dose may be necessary (see DOSAGE AND ADMINISTRATION). Venlafaxine hydrochloride, like all antidepressants, should be used with caution in such patients.

Venlafaxine HCl has not been evaluated or used to any appreciable extent in patients with a recent history of myocardial infarction or unstable heart disease. Patients with these diagnoses were systematically excluded from many clinical studies during the product's premarketing testing.

Immediate-Release Tablets

Evaluation of the electrocardiograms for 769 patients who received venlafaxine HCl in 4 to 6 week double-blind placebo-controlled trials, however, showed that the incidence of trial-emergent conduction abnormalities did not differ from that with placebo. The mean heart rate in venlafaxine HCl-treated patients was increased relative to baseline by about 4 beats per minute.

Extended-Release Capsules

The electrocardiograms for 357 patients who received venlafaxine HCl extended-release and 285 patients who received placebo in 8- to 12-week double-blind, placebo-controlled trials in depression and the electrocardiograms for 311 patients who received venlafaxine HCl extended-release and 153 patients who received placebo in 8-week double-blind, placebo-controlled trials in GAD were analyzed. The mean change from baseline in corrected QT interval (QT) for extended-release venlafaxine HCl-treated patients was increased relative to that for placebo-treated patients (increase of 4.7 msec for venlafaxine HCl extended-release and decrease of 1.9 msec for placebo). The clinical significance of these changes is unknown. The mean change from baseline in corrected QT interval (QTc) for venlafaxine HCl extended-release-treated patients in the GAD studies did not differ significantly from that with placebo.

In these same trials, the mean change from baseline in heart rate for extended release venlafaxine HCl-treated patients was significantly higher than that for placebo (a mean increase of 4 beats per minute for venlafaxine HCl (extended release) and 1 beat per minute for placebo). The mean change from baseline in heart rate for venlafaxine HCl extended-release-treated patients in the GAD studies was significantly higher than that for placebo (a mean increase of 3 beats per minut for venlafaxine HCl extended-release and no change for placebo.) The clinical significance of these changes is unknown.

Information for Patients

Physicians are advised to discuss the following issues with patients for whom they prescribe venlafaxine HCl:

Interference with Cognitive and Motor Performance: Clinical studies were performed to examine the effects of venlafaxine on behavioral performance of healthy individuals. The results revealed no clinically significant impairment of psychomotor, cognitive, or complex behavior performance. However, since any psychoactive drug may impair judgment, thinking, or motor skills, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that venlafaxine HCl therapy does not adversely affect their ability to engage in such activities.

Concomitant Modification: Patients should be advised to inform their physicians if they are taking, or plan to take, any prescription or over-the-counter drugs, since there is a potential for interactions.

Alcohol: Although venlafaxine HCl has not been shown to increase the impairment of mental and motor skills caused by alcohol, patients should be advised to avoid alcohol while taking venlafaxine HCl.

Allergic Reactions: Patients should be advised to Notify their physician if they develop a rash, hives, or a related allergic phenomenon.

Pregnancy: Patients should be advised to Notify their physician if they become pregnant or intend to become pregnant during therapy.

Nursing: Patients should be advised to Notify their physician if they are breast-feeding an infant.

Laboratory Tests

There are no specific laboratory tests recommended.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenesis: Venlafaxine was given by oral gavage to mice for 18 months at doses up to 120 mg/kg per day, which was 16 times, on a mg/kg basis, and 1.7 times on a mg/m2 basis, the maximum recommended human dose. Venlafaxine was also given to rats by oral gavage for 24 months at doses up to 120 mg/kg per day. In rats receiving the 120 mg/kg dose, plasma levels of venlafaxine were 1 times (male rats) and 6 times (female rats) the plasma levels of patients receiving the maximum recommended human dose. Plasma levels of the O-desmethyl metabolite were lower in rats than in patients receiving the maximum recommended dose. Tumors were not increased by venlafaxine treatment in mice or rats.

Mutagenicity: Venlafaxine and the major human metabolite, O-desmethylvenlafaxine (ODV), were not mutagenic in the Ames reverse mutation assay in Salmonella bacteria or the CHO/HGPRT mammalian cell forward gene mutation assay. Venlafaxine was also not mutagenic in the in vitro BALB/c-313 mouse cell transformation assay, the sister chromatid exchange assay in cultured CHO cells, or the in vivo chromosomal aberration assay in rat bone marrow. ODV was not mutagenic in the in vitro CHO cell chromosomal aberration assay. There was a clastogenic response in the in vivo chromosomal aberration assay in rat bone marrow in male rats receiving 200 times, on a mg/kg basis, or 50 times, on a mg/m2 basis, the maximum human daily dose. The no effect dose was 67 times (mg/kg) or 17 times (mg/m2) the human dose.

Impairment of Fertility: Reproduction and fertility studies in rats showed no effects on male or female fertility at oral doses of up to 8 times the maximum recommended human daily dose on a mg/kg basis, or up to 2 times on a mg/m2 basis.

Pregnancy, Teratogenic Effects, Pregnancy Category C

Venlafaxine did not cause malformations in offspring of rats or rabbits given doses up to 11 times (rat) or 12 times (rabbit) the maximum recommended human daily dose on a mg/kg basis, or 2.5 times (rat) and 4 times (rabbit) the human daily dose on a mg/m2 basis. However, in rats, there was a decrease in pup weight, an increase in stillborn pups, and an increase in pup deaths during the first 5 days of lactation, when dosing began during pregnancy and continued until weaning. The cause of these deaths is not known. These effects occurred at 10 times (mg/kg) or 2.5 times (mg/m2) the maximum human daily dose. The no effect dose for rat pup mortality was 1.4 times the human dose on a mg/kg basis or 0.25 times the human dose on a mg/m2 basis. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Labor and Delivery

The effect of venlafaxine HCl on labor and delivery in humans is unknown.

Nursing Mothers

Venlafaxine and ODV have been reported to be excreted in human milk. Because of the potential for serious adverse reactions in nursing infants from venlafaxine HCl extended-release, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

Approximately 4% of extended-release venlafaxine HCl-treated patients in placebo-controlled premarketing depression and GAD trials were 65 years of age or over. Of 2897 immediate use venlafaxine HCl-treated patients in premarketing phase depression studies, 12% (357) were 65 years of age or over. No overall differences in effectiveness or safety were observed between geriatric patients and younger patients, and other reported clinical experience has not identified differences in response between the elderly and younger patients. However, greater sensitivity of some older individuals cannot be ruled out. As with other antidepressants, several cases of hyponatremia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) have been reported, usually in the elderly.

I was recently prescribed Effexor XR (150 mg) to treat moderate depression and generalized anxiety disorder, and my initial exposure of it was to begin with 37.5 mg doses for the first few days, then step up to 75 mg for a few days, and then begin taking the "maintenance" dose of 150 mg.

My behavior altered dramatically while on Effexor XR. I became substantially more depressed and very demotivated, and began withdrawing from interaction with friends/family. I was lethargic (a night/day change, since I'm usually very energetic) and uninterested in many things that had previously occupied my time/energy.

I have to admit that Effexor DID work for the description of my "symptoms" as I relayed them to my doctor. I had asked to be prescribed something that would take the peaks and valleys out of my extreme and "knee jerk" reactionary habits, but I did not want something that would flat-line my emotions.

The peaks and valleys were definitely removed, but the flat-line effect also came into play. It significantly altered my usual outspokenness with regard to how I react/overreact to situations/events...basically, it eliminated my desire to react at all.

Just a personal observation...

I was prescribed this med on the 10th.....started at 37.5mg for the first week, which I'm still in, and then up to 75mg after that. I'm also prescribed 1mg clonazepam 2 times daily as needed for panic attacks. I have always been skeptical of the anti-depressant type drugs, and have had adverse effects to the ones that I have been scripted (paxil, lexapro, celexa, zoloft), but I really have a good doctor that I trust (which is absolutely priceless), and he told me that effexor works in a different way than the ones I named. I really need someone that has experience taking this med for at least a month or longer to tell me their opinion on this med and if it has noticable
positive/negative effects. Any information anyone could give me would be greatly greatly appreciated!!

I am also prescribed to 4mg of suboxone twice a day....pretty important info I forgot to mention.....

ok, I've been on this med (effexor xr) for almost 10 years. The 2 most noticeable side effects for me where slight nausea and lack of libido. The nausea was combated by taking it before bed only. I was up to 300mg daily. The libido thing became a problem, so recently my doc switched me from effexor to wellbutrin. Huge mistake! I suffered terrible anxiety verging on rage. Also went into a deep depression like you would not believe. They couldn't get me off that and back on effexor fast enuf. Right now I am at 150mg, but in 2 more weeks will be back to the 300mg.

Honestly, it's been the best a/d for me personally. I've suffered with depression since I was little. Been round the block w/all sorts of a/d's including the ones you listed. Hopefully this will work well for you, just keep in mind that everyone's body chem is different. I have read some real horror stories from others taking effexor. The other very important thing to remember is to never just go off this med, the w/d's are horrendous.

Good luck and I really hope my story helps.

I was on it for around 8 months made my anxiety worse that's all I can say it was a long time ago so I dont remember much but I stopped taking it so I guess it was not working out.

One thing is (I think) most people do not gain weight on it.

Sorry not much help.

"very demotivated" I have found that all the AD I've used have had that same effect.

Effexor inhibits reuptake of serotonin and norepinephrine, it may not be your mix, and the sad part of antidepressants is that it's really just trial and error. If you're looking to switch, I have a few suggestions.

One drug I would recommended trying, if you're looking to switch are Lexapro (escitalopram) - an SSRI I know, but the MOST selective of the bunch so it tends to mitigate side effects more so than any other SSRI.

The other that could be given a shot is Wellbutrin (Bupropion). Is has very different effects, inhibiting the reuptake of dopamine and norepinephrine. It has the benefit of not being shown to cause weight gain or sexual dysfunction. It also has been shown to be even more effective when combined with an SSRI (we're talking nearly 80% of people have improved who haven't responded well to SSRI's.

Perhaps what you're looking for though is Stablon (tianeptin). Rather than inhibiting serotonin reuptake, it enhances it. This may seem rather contradictory, but unlike the mood blunting effects of SSRI's, it is more associated with mood elevation.

Maybe you should read up on these and talk to your doctor about alternative choices. Even though my depression has apparently been a bit different than yours (resulting in a complete lack of motivation), I know how horrible it is to live with and if you're unhappy with your current course of treatment, there should be nothing stopping you from trying to improve it.

I would ask for Lexapro.

thanks for all you guys input! really need to know some of this stuff....I'm gonna keep on taking the effexor until my next dr appointment

I've had success or as much as one can have with one of these meds. I've been on it two different times over the years. Currently I'm on 150mg XR. I would say give it a chance.

I will never take effexor, or any other anti-depressant again. My doc had me on effexor 75mg for a while, and over time it began to lose it's effect. Rather than up my dose, he wanted to change me to Lexapro and just cease the Effexor cold turkey (his reasoning when I questioned this was bc it was a low dose, but Im very small to begin with, right at 100lbs). I questioned this bc many years ago I had quit Paxil cold turkey and went crazy, thinking irrationally, breaking things. So it was a concern. Well, after about 2 days off of Effexor, guess what happened?? I could not even control myself, my family ended up calling the cops that took me to the ER. I was under security watch bc I was a danger to myself and others, and THEN I was transferred to a psych ward out of town. Stayed there for 2 days and now Im back. Not ONE time did anyone even bring up the issue of quitting Effexor cold turkey, and it wasn't until I began thinking rationally that it dawned on me and I researched it , only to find similar stories. SO==as a result of all of that, Im stuck with almost $4000 in med bills (no insurance), lost my fiance bc he now thinks Im crazy, and trying to start all over. BUT: Im not on any antidepressants anymore, no matter how bad it gets. Just be careful if your docs ever try to have you quit cold turkey rather than taper, no matter how low the dose or how long you've been on it.

I'm sorry that happened to you, C4Q. I can go a couple days forgetting my Effexor and I get dizzy or nauseated. Then I remember. Did the Dr put you on Lexapro while you were coming off the Effexor? If not, that could be what caused it.

I am currently weaning myself off of Effexor XR as we speak. I am not even at work today because my withdrawl symptoms are so miserable, which is in part my fault, I tried to speed up the weaning process But I have never been so unhappy on a prescription med. I was prescribed this after my friend died last December and my anxiety/depression was at an all time high. The doctor who prescribed it to me put me on 300mg of XR and everything actually seemed good in the beginning. I considered Effexor being a positive force in my life. Then after a few months I began to flatline in regards to depression and anxiety symptoms and actually started to find them worsening. I noticed that if I took my dose 10-12 hours late I would get these MISERABLE withdrawl symptoms...these almost head shocks I can't even explain them...dizzyness, nausea, it is extremely hard to function, and even after taking the late dose I will still feel these for 10-12 more hours. Eventually if I missed my dose by an HOUR these symptoms began to occur. This scared me. If I ever lost my medicine or forgot it I knew I would be screwed. One hour late on my dose was hell and a day late was something I was too scared to have hanging over my head as a possibility everyday. My mother is a ARNP and helped me slowly wean myself off. In 4 months I have now gotten down to 75mg of the Effexor XR and I tried to go cold turkey last night thinking I'd be fine since I wasn't on too much anyways. Ya, bad idea, and now I am home from work and unable to drive due to my dizzyness and head shocks.

Overall, please please please do research before going on this med, especially when it comes to dosage and who prescribes it. Some psychiatrists should not be trusted so easily, especially when this going to drastically change your quality of life, to either better or worse, you live with these results, NOT them. In the end I found a different psychiatrist who has been helping me withdrawl from the Effexor, and when he looked up in his book of psychiatric drugs and side effects effexor XR, he found that the MAXIMUM dose for an adult is 200mg........sadly I was prescribed 300mg and I am a very petite 21 year old female. No wonder I felt so horrible. My last complaint is that for the majority of this time I had no insurance and paid out of pocket 75 dollars for each of my 15 effexor pills. When you take two pills a day 15 isn't going to last you a long time....


Sorry so long, but this subject is a touchy one as I am experiencing withdrawl effects as we speak and now sitting at home instead of at work thanks for letting me vent.....

I know how you feel. I remember having to withdrawal from effexor. It was very bad. I am so glad it is all over now, and it will be for you too soon. When you are off of these evil pills then you will feel brand new. Atleast that is how I felt. I felt like I was starting over, it was really strange, like I was gone in another world the whole time I was taking it. And I can also relate to the "head shocks" lol. I dont know how to explain that feeling either, it is like a lightning bolt going through your body or something. I hated it.

If you ever need to vent please dont hesitate to come on here and do just that. There are wonderful people on this board that are here to listen and offer support. I hope that your withdrwal process will be over soon, and you will be able to get back to a more normal life again. Good luck!

Effexor XR is pure evil. The twisted little bi-polar, Indian Psychiatrist who put me on this "wonder drug", must've been dipping into the samples because she's now left Psychiatry for? and she was only 30. My new Dr. handling this problem is only keeping me on it until he finds something safer. But as with most of us, this was a wonder drug, for the first few months. It's been a year now and anything over 150mg causes me to get and if I drink just 1 cup of coffee and I'm a large guy with a pretty high tolerance for most drugs.

I applaud anyone who was able to get off Effexor and get their life together again. Hopefully I'll be joining that group soon, too.

OH, boy, Effexor...what can I say? I was on it for 5 years - 225mg to 300 mg. I would also get dizzy, etc when I missed a dose, but my time period was 4 hours. I found out that if I took St. John's Wart about every 2 hours I could make it thru a day, just barely.

I got off it very fast. I had a long migraine/vomitting/headache fit for about a week and each one aggrevated the other (drove myself to hospital for fluids several times). Well, when I could take a pill, I chose to take my anti seizure and blood pressure medications. I mean, you gotta make priorities and I knew I wouldn't have a seizure or stroke without Effexor. That was the worst week of my life, right up there with the pancreatitis years ago. After everything was better, I figured I'm 7 days into a complete w/d so I'd just skip it. It wasn't working anyways.

It is a total [censored] to come off of. I had problems getting on it, but the neuro swore to me, it would help my migraines (yeah, right).

Some are really sensitive to it, and man, one hour late is really sensitive. My neuro thought 4 hours was sensitive.

OH, little side note....before all this, I was hospitalized. The EMS had grabbed all my meds. So, they were giving me my own meds and kept them behind the nurse's station. Someone stole almost a whole bottle of Effexor. And the hospital's way to "make it right" was to give me a script for it. Weeehhheeeee.

Hang in there, you may have to go down to the 37.5mg dose. Or, like I said the St. John's Wart took away the w/d feelings when I missed a dose. Maybe that's worth a try??

This thread is old but, has anyone had any positive experiences on effexor? I am weaning off Celexa, to be switched to effexor. I was on 80mg of Celexa but built a tolerance to it, so my shrink is switching me. Any feedback would be appreciated.

Kelmom: I've been on effexor for about 3 years. I haven't had any of the bad experiences that the above posters have. It works well for me, with no negatory side effects.

It's good that St John's Wort worked for you, but it's risky taking it with other antidepressants, because it can inhibit their metabolism, leading to effective overdose when it wears leaves the system.

Wow - I was beginning to think I was the only one here who actually LOVED their Effexor. It's definitely been the best choice for me, and I've been on it for a year now. I'm at 450mg, but it's definitely made an improvement in my life. I have motivation when I didn't before. It even kind of gives me a jolt in the morning. Someone had told me once it has something in it that is very close to an amphetamine? I don't know what to believe. All I know is it works the best for me