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FREE MENTAL HEALTH ASSESSMENT. start here
Reviewed by Jill Johnson, DNP, APRN, FNP-BC
Written by Geoffrey C. Whittaker
Published 04/21/2022
Updated 07/19/2021
Antidepressant drugs are complicated medications. They’re one of the few types of prescription drugs that cross the blood-brain barrier, a crucial protective layer that keeps harmful bacteria, viruses and other unwanted compounds out of the brain.
They work in a complex way, requiring rigid adherence to dosing as given by your healthcare provider to perform effectively.
And as you might suspect, they’re not great to take during a night of heavy drinking.
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Not taking antidepressants mid-bar crawl might be a “duh” moment for many people, but even less obviously troubling combinations of antidepressants and alcohol can create some potentially serious complications.
One of the antidepressant medications that doesn’t react well with alcohol is Effexor®.
According to the National Institute of Mental Health (NIMH), depression is a mood disorder. Depression is defined as a condition of recurring patterns of empty, sad and down feelings, as well as a loss of interest in daily activities.
Researchers don’t know why feelings of depression happen exactly, but various biological, genetic, psychological and environmental factors may impact risk levels of depression.
People experiencing feelings of depression may have an array of symptoms of depression, but the commonly occurring symptoms include mood changes like anger, exhaustion or irritability.
Depression can lead to sleep issues, reckless behavior, weight fluctuation, substance abuse and lost interest in things you like. It can also cause stomach issues.
Perhaps most importantly, depression can lead you to suicidal thoughts — something you should talk to a healthcare professional about immediately if you’re experiencing.
Effexor is the brand name version of venlafaxine hydrochloride: a selective serotonin and norepinephrine reuptake inhibitor, or SNRI.
These are two important neurotransmitter chemicals for the brain’s normal function, as your serotonin level manages mood, and your norepinephrine level manages stress responses.
SNRIs are one form of antidepressant. Like other antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), they are medications designed to impact chemical balances to treat mood disorders beyond the blood brain barrier.
Effexor is traditionally prescribed to treat several conditions, including major depressive disorder (MDD). It is also frequently prescribed for anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder.
Effexor is sometimes prescribed off-label for attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and other disorders.
It is also occasionally used to treat hot flashes, premenstrual dysphoric disorder (PMDD), migraines and diabetic neuropathy.
Effexor has two delivery formats: it can be taken as a daily extended release tablet or as an immediate release tablet, which can be taken several times a day. Still, it may take four to six weeks of use for Effexor to become effective.
Effexor (venlafaxine) and alcohol have a tumultuous relationship at best. The two do not mix well, to say the least, but there may also be a reason that people suffering from alcohol addiction should consider Effexor with the help of a healthcare provider.
Alcohol and medications generally do not mix well. That’s a well-proven trend across all medication types, including antidepressants — and Effexor is no exception.
It's recommended that Effexor be taken with food, and not consumed with alcohol. Combining this medication and alcohol can lead to increased sedation, and the same goes for an empty stomach.
The data on Effexor and alcohol is unnerving, to say the least.
Within certain guidelines, Effexor is actually an effective medication for treating certain kinds of alcoholism, like depressive alcoholism. Generally, it has been shown to lessen the symptoms of alcoholism and can be effective as a depression treatment alongside alcoholism.
All of that, of course, assumes that no one taking effexor for alcoholism is simultaneously drinking.
And there’s another reason to be vigilant about taking effexor for depression — suicides and overdoses using effexor and other antidepressants often include alcohol.
While Effexor is generally safe and effective, it does have some mild side effects that patients should be aware of.
Common side effects include issues with sleeping, gastrointestinal issues, sedation, impaired sexual function and cardiovascular side effects.
Other common adverse effects may include:
Loss of appetite
Weight loss
Nightmares
Uncontrollable shaking
Headache
Nervous feelings
Dizziness
Stomach pain
Heartburn
Nausea
Diarrhea
Dry mouth
Increased sweating
If you begin taking Effexor and experience any of these side effects, talk to your healthcare provider as soon as possible — especially if they persist and/or worsen. A healthcare professional may offer lower dosage to reduce your risk of side effects.
Contact your healthcare provider immediately if you experience any of the following serious side effects:
Chest pain
Problems with coordination or hallucinations.
Unusual bruising or bleeding
Fever
Eye pain or redness
Confusion
Rash
Hives
Itching
Seizures
In rare cases, serotonin syndrome, mania, issues with platelet function and exacerbated depression can also be side effects, as can increased suicidality. Rarest side effects include coma, and some serious side effects can result in death if not addressed.
It’s also worth noting that Effexor comes with a blackbox warning by the FDA, which means that in children, adolescents and young adults, it was shown to increase suicidal thoughts.
To learn about another potential Effexor side effect, you can read our blog on Effexor and weight gain.
Effexor has some potentially complicated drug interactions to be aware of. You should let a healthcare provider know if you’re taking monoamine oxidase inhibitors (MAOIs), linezolid or methylene blue. It should be used cautiously alongside any medications that increase levels of serotonin.
Some weight loss drugs used alongside Effexor may result in excessive weight loss, serotonin syndrome and potentially serious heart problems.
Effexor can also lessen the effectiveness of beta blockers, and can also cause occasional false positives in amphetamine and PCP urine tests.
Depression is best treated with a holistic approach, and so while medications like Effexor may be an effective treatment option for you, you might consider other resources to support the medication and enhance your personal growth on your mental health journey.
Well-known therapy forms like Cognitive Behavioral Therapy (CBT) are designed to help patients create a system for recognizing dysfunctional thought patterns to help the patient gain awareness and, ultimately, control.
Psychotherapy could include techniques like mindful meditation, which teaches you to observe your episodes and learn not to pass judgement on yourself for struggling.
Lifestyle changes, including a focus on improving diet, weight, blood pressure or exercise might also be beneficial—an exercise regimen, for instance, has been shown to be as effective as medication in some cases of depression.
Despite the potentially worrisome list of side effect warnings, the simple answer is that for most people, Effexor is a safe and effective medication that is effective in treating depression.
But you need to be vigilant if using it — that means not using it with alcohol.
When used with alcohol, Effexor may result in higher levels of sedation, and there’s research to suggest a correlation between alcohol use with Effexor and elevated risks of overdose and suicide.
Basically, if you’re thinking about using Effexor with alcohol, don’t. Just… Don’t. Make sure you’re always following the prescription instructions provided by your healthcare provider, and don’t stray from them.
Effexor is a serious medication, and its warnings should be taken seriously. That may mean changes to your current lifestyle, like cutting back on drinking.
It’s important to consider these choices within the larger question about what’s important to you — if you’re seeking help and medication for your mental health, it would make sense to alter your lifestyle to give those treatments the best chances to help you succeed, and to eliminate the potential for serious injury.
If you haven’t begun taking Effexor, we know some of this information can sound a bit scary.
The best way to work through those fears is to learn more about depression and its treatments, and ask questions.
A healthcare professional can help you understand and put fears of yours to rest, but we have resources available as well.
Our guide to the types of therapy and our mental health resources guide are great places to start for more information on your mental health journey.
If you’re ready to talk to someone now, consider scheduling an evaluation to get depression medication online today.
Dr. Jill Johnson is a board-certified Family Nurse Practitioner and board-certified in Aesthetic Medicine. She has clinical and leadership experience in emergency services, Family Practice, and Aesthetics.
Jill graduated with honors from Frontier Nursing University School of Midwifery and Family Practice, where she received a Master of Science in Nursing with a specialty in Family Nursing. She completed her doctoral degree at Case Western Reserve University.
She is a member of Sigma Theta Tau Honor Society, the American Academy of Nurse Practitioners, the Emergency Nurses Association, and the Air & Surface Transport Nurses Association.
Jill is a national speaker on various topics involving critical care, emergency and air medical topics. She has authored and reviewed for numerous publications. You can find Jill on Linkedin for more information.