ADHD Medication and Treatment Reviews

Effexor XR (venlafaxine)

Generic Name: Venlafaxine

What is Effexor XR?

Effexor XR (generic name: venlafaxine) is a once-daily serotonin and norepinephrine reuptake inhibitor (SNRI) medication primarily used to treat depression, anxiety, and panic disorders in adolescents and adults. Effexor XR is not approved for use in people under 18 years of age. Its safety has not been established for children.

Effexor XR is also used to treat nerve pain from diabetes, fibromyalgia, and chronic musculoskeletal pain.

Some clinicians prescribe venlafaxine for the treatment of ADHD symptoms in adults who do not tolerate first-line stimulant or non-stimulant medications, however a 2012 double-blind study calls into question its effectiveness as an ADHD treatment1.

How to Use Effexor XR

Before starting or refilling an Effexor XR prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage for Effexor XR

As with all medications, follow your Effexor XR prescription instructions exactly. Effexor XR is taken orally, once daily with food. Capsules should be swallowed whole with water or other liquids.

Do not crush, chew, or dissolve this medication. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow whole without crushing or chewing.

If you have trouble swallowing the capsules whole, you may open the capsule and sprinkle the contents onto a spoonful of applesauce. Swallow all of the mixture right away without chewing. Drink a glass of water after each dose.

Effexor XR is available in capsules, tablet (HCL salt) and extended-release (HCL salt) tablets.

The optimal dosage varies based on the condition treated. If you have certain health conditions, like renal or hepatic impairment, your doctor may recommend a lower dosage.

For updated information about dosages, interactions, and precautions, see the Effexor XR drug monograph on WebMD.

Your doctor may incrementally adjust your daily dosage until you experience the best response — that is, until you find the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

During treatment, your doctor should evaluate your height and weight because Effexor XR can cause changes in appetite. If any problems are found, your doctor may recommend discontinuing treatment.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication. Stopping Effexor XR suddenly can create withdrawal symptoms including agitation, irritability, loss of appetite, anxiety, confusion, impaired coordination/balance, diarrhea, dizziness, dry mouth, fatigue, headache, nausea, difficulty sleeping or excessive sleepiness, and electric shock sensations.

Side Effects Associated with Effexor XR

The most common side effects of Effexor XR are similar to those associated with other SNRIs, and are as follows: unusual dreams, sexual problems, loss of appetite, constipation, diarrhea, nausea or vomiting, dry mouth, excessive sleepiness or difficulty sleeping, tremors, dizziness, blurred vision, swearing, anxiety, headache, or increased heart rate.

Other serious side effects include increased risk of suicidality or manic episode, vision problems including angle closure glaucoma, changes in blood pressure, elevated cholesterol, abnormal bleeding, low salt levels in the blood, seizures, trouble with urination, lung disease, and changes in appetite or weight. Patients should be monitored and observed closely for worsening depression, changes in behavior, or suicidality, especially when starting treatment or changing dosage.

Taking Effexor XR may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide, bipolar disorder, mania, or depression. The manufacturer recommends evaluating patients for bipolar disorder prior to the administration of Effexor XR to avoid inducing a manic episode. Effexor XR may create new or exacerbate existing behavior problems, bipolar disorder, or suicidal ideation, especially in the first few months of treatment or after a dosage change. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including reckless behavior, hallucinations, or sudden excessive happiness or irritability.

Do not drink alcohol while taking Effexor XR.

Effexor XR increases serotonin levels in the brain, and can rarely lead to life-threatening serotonin syndrome, or toxicity. If you or your teen experiences changes in mental status, coordination problems, muscle rigidity, racing heartbeat, high or low blood pressure, sweating, vomiting or diarrhea, seek medical help immediately.

Discuss any bleeding disorders or irregular sodium levels with your doctor. Effexor XR can cause abnormal bleeding for some patients, and low salt concentration in the blood. The elderly may be at greater risk for these problems.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Effexor XR

Store Effexor XR in a secure place out of the reach of children, and at room temperature. Do not share your Effexor XR prescription with anyone, even another person with depression. Sharing prescription medication is illegal, and can cause harm.

You should not take Effexor XR if you are allergic to any of the ingredients in Effexor XR, have taken a monoamine oxidase inhibitor (MAOI) within 14 days, or have uncontrolled angle-closure glaucoma.

You should use caution when taking any SNRIs, including Effexor XR, and speak with your doctor if you have liver or kidney problems, diabetes, thyroid problems, seizures, bipolar disorder, low blood sodium levels, a history of stroke or high blood pressure, high cholesterol, or a history of bleeding problems.

If you’re thinking of becoming pregnant, discuss the use of Effexor XR with your doctor. It is not known if Effexor XR can cause fetal harm during pregnancy. It is recommended that mothers do not nurse while taking Effexor XR, as its safety for infants is unknown.

Interactions Associated with Effexor XR

Before taking Effexor XR, discuss all other active prescription medications with your doctor. Effexor XR can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs. Taking Effexor XR while taking blood thinners like Coumadin, ibuprofen, or aspirin can increase the risk of abnormal bleeding.

Using Effexor XR concurrently with medication that increases serotonin – like St. John’s wort, triptans, SSRIs, other SNRIs, linezolid, lithium, tramadol, or street drugs like MDMA – can increase the risk of serotonin syndrome.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications, you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Effexor XR before having any surgery or laboratory tests.

Some medications and supplements that can interact with Effexor XR include: cimetidine; triptans for migraines; medicines used to treat mood, anxiety, and thought disorders; and tramadol.

The above is not a complete list of all possible drug interactions.

1Amiri S, Farhang S, Ghoreishizadeh MA, Malek A, Mohammadzadeh S. “Double-blind controlled trial of venlafaxine for treatment of adults with attention deficit/hyperactivity disorder.” Human Psychopharmacology. 2012;21(1):76-81.doi: 10.1002/hup.1274