Is Effexor good for social anxiety?

What is Effexor?

Effexor (trade name for Venlafaxine) is a medication belonging to the class of the serotonin-norepinephrine reuptake inhibitors (SNRIs), used in the treatment of panic attacks, social anxiety, generalized anxiety, and major depressions. The immediate release formulation for Effexor tablets was introduced for the first time in 1993, while the extended release alternative (Effexor XR) was launched four years later.

Other SNRIs approved by FDA for treating depression and anxiety:

  • Cymbalta (Duloxetine)

  • Pristiq (Desvenlafaxine)

Effexor is considered to be the most prescribed SNRI across the US.

  1. How Effexor works

Effexor regulates the level of two chemical messengers that naturally occur in the brain: serotonin and norepinephrine (noradrenaline). These neurotransmitters are believed to be responsible for controlling the feeling of well-being and mood balance.

A low dose of Effexor is enough to block the reuptake of serotonin but for preventing both serotonin and noradrenaline from being reabsorbed in the brain, larger doses are required.

  1. Effexor effectiveness for social anxiety

Effexor is generally prescribed when the treatment with selective serotonin reuptake inhibitors (SSRIs) failed to work.

The conclusion of the medical trial, published in the British Journal of General Practice, about Effexor effects in 271 patients with social anxiety stated that the medication:

  • is safe

  • is well tolerated

  • reduces anxiety symptoms in both people who are depressed or not

  • provides significant improvement after 24 weeks of treatment

There is another well-known study, published in The British Journal of Psychiatry, which made a comparison between the remission rates of Effexor, SSRIs and placebo. The trial encompasses a wide number of patients: 851 persons received Effexor XR, 748 people were treated with SSRIs (Prozac, Luvox, and Paxil), and 446 persons were included in the placebo group.

The results showed that Effexor provided the highest efficacy regarding the remission of symptoms:

  • 45% remission rate for Effexor

  • 35% remission rate for SSRIs

  • 25% remission rate for placebo

  1. Common adverse reactions

  • nausea

  • excessive sweating

  • dry mouth

  • feeling nervous

  • sleepiness

  • blurred vision

  • abnormal dreams

  • stomach upset

  • heartburn

  • decreased appetite

  • sexual dysfunctions

  • irregular bowel movements

  • headaches

The risk of dealing with adverse reactions substantially increases when Effexor is taken in combination with anti-inflammatory painkillers sold over the counter.

  1. Rare side effects

  • increased blood pressure: Considerable changes in blood pressure are likely to occur at higher doses of Effexor (above 300 mg per day). There are no visible hypertension problems at doses bellow 225 mg per day.

  • low concentration of sodium in the blood: It usually appears in elderly people and those patients who are taking diuretics. The patient experiences concentration problems, weakness, slurred speech, and shaking.

  • increased level of cholesterol

  • stiff muscles

  • enlarged pupils

  • abnormal bruising

  • breathing difficulties (chest pains)

  • serotonin syndrome: The serotonin syndrome is caused by an elevated concentration of serotonin that has life threatening potential. This situation happens when two drugs that play the same role, to raise serotonin level, are combined. The symptoms typical to serotonin syndrome include:

  • fever

  • fast heartbeat

  • agitation

  • loss of consciousness

  • hallucinations

  • variations in blood pressure

  • upper gastrointestinal bleeding: The use of Effexor next to aspirin, ibuprofen, and anticoagulants like heparin or warfarin triggers the risk of internal bleeding.

  • allergic reactions

The signs of Effexor allergy:

  • skin rashes

  • face and tongue swelling

  • breathing discomfort

  • swallowing problems

  • exacerbation of suicidal thoughts: There are reports about persons whose depression began to worsen after starting the treatment with Effexor and also, they developed hostility and signs of suicidal behavior. According to FDA statistics, the thoughts of self-harm and ending life occurred mostly in patients under 25.

  • skin becomes sensitive to sunlight: It is advisable to avoid exposure to strong sunlight or tanning bed. If there are any signs of skin reactions, apply a high SPF sunscreen.

  • risk of miscarriage: The Canadian Medical Association Journal gave warning that pregnant women should take Effexor only if it is absolutely necessary. Effexor considerably increases the risk of miscarriage.


Effexor is effective in the treatment of social phobia as long as it is taken following the doctor’s prescription in a strict manner. It should be avoided higher or lower doses that the recommended one.

Effexor works slowly so that it takes about 4 weeks until the anxiety symptoms start to decrease. When any side effects occur, you have to inform your doctor or healthcare professional immediately.

Just like in the case of other antidepressants, Effexor does a better job when is administered together with psychological therapy, which addresses the underlying reasons of social anxiety.