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SNRI Antidepressant

Venlafaxine

Brand names: Efexor XL

Used in: Depression & Anxiety

Venlafaxine is a serotonin-noradrenaline reuptake inhibitor (SNRI) used for depression and some anxiety disorders, often after an SSRI has not worked.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Initial Treatment The recommended starting dose for venlafaxine tablets is 75 mg/day, administered in two or three divided doses, taken with food. Depending on tolerability and the need for further clinical effect, the dose may be increased to 150 mg/day. If needed, the dose should be further increased up to 225 mg/day. When increasing the dose, increments of up to 75 mg/day should be made at intervals of no less than 4 days. In outpatient settings there was no evidence of usefulness of doses greater than 225 mg/day for moderately depressed patients, but more severely depressed inpatients responded to a mean dose of 350 mg/day. Certain patients, including more …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-02-04. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits reuptake of serotonin and (at higher doses) noradrenaline, increasing their synaptic availability over several weeks.

Prescribing in practice

  • It can raise blood pressure in a dose-related way — monitor, particularly at higher doses.
  • Discontinuation effects can be marked because of its short half-life — taper slowly.
  • Risk of serotonin syndrome with other serotonergic drugs; caution in cardiac disease and in overdose.

Monitoring

Monitor mood and suicidal ideation early; check blood pressure, especially at higher doses.

Counselling the patient

  • It can take a few weeks to work.
  • Do not stop suddenly — withdrawal effects can occur.
  • Report worsening mood or thoughts of self-harm.

Evidence & guidelines

An option for depression where first-line SSRIs are ineffective or unsuitable (NICE NG222), with blood-pressure monitoring.

Reference: NICE CG90 (Depression); MHRA Drug Safety Update 2012; AGS Beers Criteria 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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