When is the best time to take venlafaxine?

In this article:

• Best time to take venlafaxine
• Missed dose
• Side effects
• Maximizing benefits
• The bottom line

In this article

• Best time to take venlafaxine
• Missed dose
• Side effects
• Maximizing benefits
• The bottom line

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is approved by the U.S. Food and Drug Administration (FDA) to treat mental health conditions, including major depressive disorder (MDD), generalized anxiety disorder (GAD), panic attacks caused by panic disorder, and social anxiety disorder (SAD). Also known by the brand name Effexor XR, this antidepressant is also used off-label to treat other medical conditions like neuropathic pain, fibromyalgia, and chronic pain syndromes. The best time to take venlafaxine is different for every person and depends on the formulation you’re taking and how the medication affects you. 

Should I take venlafaxine in the morning or at night?

There are two main factors that help determine when you should take venlafaxine: 

how it affects you and the formulation you are prescribed. The most important thing is to take it consistently at the same time(s) every day. 

Side effects

“There’s no one-size-fits-all answer here,” says Savana Howe, Psy.D., clinical psychologist and founder of Dr. Howe Psychology. “Some people feel a little more awake or even jittery after taking it, so mornings might be better.” 

Others may find the medication calming or sedating and prefer to take it in the evening. “Venlafaxine can also cause daytime sedation in some individuals,” says Taher Saifullah, MD, founder of the Spine & Pain Institute in Los Angeles, California. “Adjusting the time of dosing can help.” Your healthcare team can help you adjust the timing depending on how it makes you feel. 

Generally, venlafaxine should be taken with food to reduce gastrointestinal side effects, such as nausea. Taking it in the evening may work better if you tend to skip breakfast. “This medication can be life-changing for many, but like all medications, it works best when used with understanding and care,” adds Dr. Howe.

Formulation

Venlafaxine is available as immediate-release tablets and extended-release tablets or capsules. Immediate-release (IR) formulations are usually taken twice daily in the morning and evening, about 12 hours apart. Some people are prescribed this version to be taken three times daily, about eight hours apart. Extended-release (XR) formulations are taken once daily at the time that works best for you, and should be taken at about the same time every day.

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What if I miss a dose of venlafaxine?

Even the most organized people can forget to take a dose of medication. What to do next depends on the last time you took a dose, says Edmond Hakimi, DO, internist and medical director at Wellbridge.

“If you miss a dose, take it as soon as you remember,” Dr. Hakimi says. However, if it is almost time for the next dose, skip the missed one. Do not double up. If you’re not sure what to do, check with your healthcare provider or pharmacist.

“Venlafaxine has a short half-life, meaning even missing one dose can trigger withdrawal symptoms like dizziness, brain zaps, or mood changes,” explains Dr. Hakimi. “So consistency is key. If you miss doses frequently, talk to your provider about strategies to stay on track.”

What are the side effects of venlafaxine?

Like any prescription medication, there are potential venlafaxine side effects that can vary from mild to severe. Common side effects include:

• Anxiety or nervousness
• Drowsiness or tiredness
• Dizziness
• Constipation or diarrhea
• Decreased appetite
• Dry mouth
• Excessive sweating
• Nausea or vomiting
• Sexual problems
• Tremors or shaking
• Trouble sleeping
• Yawning 
• Unusual dreams

If you experience any of the following serious side effects, seek emergency medical help as soon as possible:

• Allergic reactions (hives, swelling, difficulty breathing)
• Bleeding, including in stool or vomit
• Heart rhythm changes, such as a fast or irregular heart rate, or feeling lightheaded
• Increase in blood pressure
• Loss of appetite with weight loss
• Low sodium level (headache, weakness, confusion)
• Serotonin syndrome
• Sudden eye pain or a change in vision
• Suicidal thoughts, self-harm, or depression

Venlafaxine has a black box warning, the most serious safety warning issued by the FDA, due to the risk of suicidal behaviors and thoughts in adolescents and young adults under 24.

Mild side effects “often fade after a week or two,” Dr. Howe explains. “But if you notice anything more serious—like feeling super agitated, confused, very anxious, or having thoughts of hurting yourself—call your healthcare provider right away.” Or, seek emergency medical attention.

Because venlafaxine can affect blood pressure or cholesterol levels, Dr. Hakimi recommends seeking medical advice to have these levels monitored, especially if you are taking the antidepressant long-term.

Discuss any prescription and over-the-counter medications as well as vitamins and dietary supplements, you are taking with your healthcare provider. Possible venlafaxine interactions include:

• Monoamine oxidase inhibitors (MAOIs), such as phenelzine, linezolid, and methylene blue
• Antipsychotic medications like pimozide and thioridazine
• The heart rate medication quinidine
• Blood thinners like warfarin
• Non-steroidal anti-inflammatory medications (NSAIDS), like ibuprofen

This is not a complete list of drug interactions. A healthcare professional can advise you on interactions that could affect you.

How do I get the most out of my venlafaxine?

You’ll know that venlafaxine is working when you start to notice signs like improved mood, concentration, appetite, sleep, and decreased anxiety or pain. You will typically notice small improvements in sleep, energy, and appetite within the first couple of weeks. “Mood and anxiety symptoms tend to improve more noticeably after four to six weeks,” Dr. Hakimi says. “While there’s no proven way to speed up how fast it works, staying consistent with your medication, living a healthy lifestyle, and participating in therapy if recommended can support recovery.”

There’s no proven way to speed up how fast it works, but there are some easy steps you can take to maximize the effectiveness of venlafaxine:

• Take it consistently, at the same time every day. “It helps to build a steady level in your system,” Dr. Howe says. 
• Make healthy lifestyle changes. “Pairing the medication with healthy habits, like regular exercise, balanced meals, and good sleep, can also boost its effectiveness,” Dr. Howe adds.
• Avoid alcohol and limit caffeine. They can worsen side effects such as drowsiness and dizziness or jitteriness and anxiety, respectively.
• Avoid grapefruit juice. In large amounts, it can affect how venlafaxine is metabolized.
• Work with your provider and pharmacist to avoid drug interactions. Dr. Saifullah urges caution if taking St. John’s Wort, triptans, tramadol, other antidepressants, the cough suppressant dextromethorphan, or other serotonergic agents (drugs that increase serotonin levels), since there is a higher risk of developing serotonin syndrome, a rare but serious drug reaction. 
• Participate in therapy. Talk therapy is often prescribed in combination with medication to treat depression and anxiety.

If you do not notice benefits after a couple of months, let your provider know. You may need a dose adjustment or a different approach.

The bottom line 

There is no universal best time to take venlafaxine. Your response to the medication, along with the formulation prescribed, may help determine whether it’s best to take venlafaxine in the morning, evening, or both. While some people may feel more energized after taking their dose of venlafaxine and prefer taking it in the morning, others may rest better at night if they experience sleepiness after taking the medication. What matters most is consistency.

“If you’re starting venlafaxine or considering it, just know you’re not alone and that it’s okay to ask questions and adjust things as you go,” Dr. Howe says.