Does Effexor (Venlafaxine) Work for OCD?
Obsessive-compulsive disorder (OCD) is a mental health condition that can impact people of any age and from many “walks of life.” OCD involves a continuous cycle of obsessions (i.e., unwanted intrusive thoughts, urges, doubts, fear, beliefs, emotions, and/or mental images) and compulsions (i.e., rituals or routines). While obsessions trigger extremely upsetting feelings, compulsions can compel a person to (at least try) extricate the “mental intrusions” and/or reduce or eliminate his or her emotional distress (i.e., stress, angst, worry, concern, doubts, etc.).
Truth be told, most people experience intrusive thoughts and/or compulsive behaviors from time to time, however, that does not automatically mean that they have OCD. To be officially diagnosed with OCD, a person must experience an endless OCD cycle so severe that they significantly disrupt his or her life. Understand that OCD is not only draining, but also all-consuming.
The current “gold standard” OCD treatment involves cognitive-behavioral therapy (CBT), medication, lifestyle changes, and self-help tools, like Impulse Therapy, an online OCD program designed to help you better manage your OCD symptoms and receive the support, tools, and resources needed to successfully combat the intrusive thoughts and compulsive behaviors.
The “preferred” medication for OCD is serotonin reuptake inhibitors (SSRIs), antidepressants used to reduce depression and anxiety symptoms. Celexa, Prozac, Luvox, Paxil, and Zoloft are the most common SSRIs prescribed for OCD. Although SSRIs have shown success in treating OCD, some people with OCD have been unable to gain relief from them. For those, who do not respond to SSRIs, Effexor may the blessing they have been seeking.
Effexor and Effexor XR (brand name version) or venlafaxine (generic version) is a highly popular and extremely common medication that has been around for decades and is used by anxious and depressed people from all races, cultures, nationalities, religions, ages, educational backgrounds, economic statuses, genders, etc. Thus, it is used worldwide by millions of people, who are seeking relief. Understand, however, that this medication is no “magic pill” and once you start taking it for OCD, it may be a while before you experience noticeable results.
So, is it worth it to take Effexor for my OCD symptoms? Well, have you tried various SSRI medications, all of which have failed (i.e., treatment-resistant OCD)? If other medications have been unsuccessful, there is a good chance that this medication may help you better manage your OCD symptoms. However, there are some things you should know before you jump on the “Effexor train.”
The good news is this article can provide you with the information you need to determine if the next course of action should be transitioning to Effexor for your OCD.
What is Effexor and How Does It Work?
Unlike SSRIs, like Prozac, Effexor (venlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI).
What does that mean? It means it involves hormones/neurotransmitters (serotonin and norepinephrine). SSRIs, on the other hand, only involve serotonin. Researchers suggest that people with OCD are deficient in serotonin (low levels of the hormone/neurotransmitter). However, both SSRIs and SNRIs, inhibit or “slow” the reuptake (reabsorption) of serotonin, boosting the amount of it in the brain.
Effexor appears to help OCD by increasing the amount of norepinephrine in the brain. Keep in mind, however, that no studies have documented if or how increased norepinephrine levels in the brain are beneficial for OCD. Researchers have found that Effexor’s norepinephrine properties can effectively reduce mood disorders – in some people.
More specifically, studies indicate that increasing the amount of norepinephrine in the brain (in some people) may trigger feelings of happiness, good mood, and a general feeling of well-being. However, researchers also found that too much norepinephrine in the brain can lead to severe anxiety and OCD symptoms.
Are There Any Side Effects or Drug Interactions Linked to Taking Effexor for OCD?
Yes, there are.
As with any other antidepressant, Effexor (venlafaxine) can trigger a variety of side effects, such as:
- Sleepiness (Drowsiness)
- Dry “Cotton” Mouth
- Profuse Perspiration (Excessive Sweating)
- Premature Ejaculation (PE)
- Eating Disorders (Anorexia, Binging and Purging, and Bulimia)
- Mental Confusion
- Mood Swings
- Erectile Dysfunction (ED)
- Low Sexual Desire (Poor Libido)
- Suicidal Ideation (Suicidal Thoughts and/or Attempts)
Note: Keep in mind that most, if not all, of these side effects, should diminish and disappear over time. However, if they persist and/or worsen with continued use, contact your doctor for guidance immediately.
Effexor, an SNRI, may also interact with other medications – even medications commonly used to treat anxiety conditions, like OCD.
Medications that may interact with Effexor include:
- Other SNRIs (i.e., Duloxetine or Cymbalta, Desvenlafaxine or Pristiq or Khedezla, Milnacipran or Savella), or Levomilnacipran or Fetzima).
- SSRIs (i.e., Luvox, Paxil, Zoloft, and Prozac)
- Monoamine Oxidase Inhibitors or MAOIs (i.e., Isocarboxazid or Marplan, Phenelzine or Nardil, Selegiline or Emsam, or Tranylcypromine or Parnate)
- Abilify (i.e., Aripiprazole)
- Adderall (i.e., Amphetamine/Dextroamphetamine)
- Ambien (i.e., Zolpidem)
- Ativan (i.e., Lorazepam)
- St. John’s Wort
Note: In some cases, these drug interactions may lead to excessively high serotonin levels, a condition referred to as “serotonin syndrome.” Therefore, inform your doctor and pharmacist of any other medications, vitamins, herbs, etc., you are taking before using Effexor to treat your OCD symptoms.
How Much Effexor is Needed for OCD Symptoms?
Effexor, Effexor XR, and venlafaxine (the generic version) are available in tablet and capsule forms. If you are prescribed Effexor XR or extended-release venlafaxine, it is important to take the medication with food once a day. Conversely, if you are prescribed fast-acting venlafaxine, you may need to take the medication two or three times a day.
Follow the instructions provided by your doctor and take the medication exactly as prescribed. If you are prescribed capsules or tablets, do not crush, chew, or dissolve them (swallow them whole). Your doctor will likely start you off on a low dose of Effexor or venlafaxine and gradually increase it if needed. Make sure you keep your doctor informed of any new symptoms, side effects, and/or complications, so he or she can effectively “tweak” your medication (i.e., dosage, frequency, etc.).
Note: High than normal doses of Effexor or venlafaxine may be required to effectively manage your OCD symptoms.
What Is It Like to Take Effexor for OCD?
Listed below are real examples of what it is like to take Effexor for OCD:
“My OCD intrusive thoughts were destroying me. I felt that the only way out was suicide. My doctor did not seem to care. She was too involved in impressing her colleagues with her presentations. Guess who would pay for these fancy presentations? Her psychiatric patients! I was fed up so one day I went to a walk-in clinic and *tried* to discuss my OCD symptoms with a new doctor. This new doctor prescribed me 37.5mg of Effexor to take for a couple of weeks with a plan to gradually increase the dosage to 75mg.
Effexor reduced my repetitive, negative intrusive thoughts within the first week. Effexor worked. And, although my life will never be perfect, I feel so much better now that I am no longer tormented by the non-stop intrusive thoughts. I no longer see my old psychiatrist anymore, primarily because my new doctor is thorough and caring. I appreciate that. My tip to you is to be careful when selecting the right OCD treatment and the right OCD therapist.”
“I have been grappling with obsessive-compulsive disorder (OCD) and autism spectrum disorder – which arose shortly after beginning Effexor for my OCD. Before taking Effexor, I took Zoloft for 9 months, during which time I had two unintentional drug overdoses – one of which occurred while in an inpatient hospital, and one after a loved one committed suicide. Truth be told, Effexor was a godsend for the first 2 months. It “dulled me out” which is what I needed. Effexor helped stop the “noise” in my head. My cleaning and order obsessions also stopped.
I was no longer sitting anxiously (with every muscle in my body tight) on the edge of my seat. For the first time in years, my OCD symptoms went away. And, it was all due to Effexor. However, six months later I developed photophobia, diarrhea, appetite loss, mood swings with rage, a loss of taste, dramatic weight loss, extreme fatigue, nephropathy, tremors, jerking, and dystonia. If I am honest, it was the dystonia diagnosis that got my doctor’s attention. She told me it was a “sign” that it was time to stop the Effexor before it caused my damage.”
How Effective Is Effexor for OCD?
Effexor can be very effective for some people with OCD.
Effexor is not only effective for mood disorders, like depression, bipolar disorder, etc., but also for “off-label” anxiety conditions like generalized anxiety disorder (GAD), panic attacks and panic use disorder, social anxiety, post-traumatic stress disorder (PTSD), and OCD.
Understand that Effexor is not a fast-acting medication, and as such, it is highly likely that you will experience significant results in less than eight weeks, however, OCD sufferers may experience mild-to-moderate improvement in the energy levels, appetite, and sleep quality within a week or two.
If an OCD sufferer experiences some degree of improvement in one of these areas within a week or two, it is generally considered a “sign” that Effexor is working. Still, it typically takes between six and eight weeks to experience a significant improvement in OCD symptoms, like their overall moods, emotions, urges, intrusive thoughts, fears, doubts, mental images, and interest in activities and loved ones.
Conversely, if you do not receive a noticeable improvement in your OCD symptoms after eight weeks, consult your practitioner or psychiatrist about it. He or she may adjust your Effexor dosage, add another medication (i.e., an SSRI) to it, or prescribe another medication altogether to help with your OCD symptoms.
What Do the Researchers Say?
There have been relatively few studies conducted on the effectiveness of Effexor for OCD. However, researchers suggest that it may be highly beneficial for OCD. More specifical there is some evidence that Effexor may reduce OCD symptoms (obsessions and compulsions) in some people. Still, more research is needed to determine the true effectiveness of Effexor for OCD.
According to a 2003 study, approximately 76% of OCD sufferers, who have not responded to one or more SSRIs (also known as “treatment-resistant OCD”), may experience some degree of relief from symptoms after taking Effexor for their OCD symptoms. However, it is important to take these results with a “grain of salt,” due to the limited size of the study.
On the flip side, the American Psychiatric Association (APA), Effexor is “unlikely” to cause significant long-term improvement in OCD symptoms –as compared to SSRIs.
Is Effexor a First-Line Treatment for OCD?
No, it is not.
Currently, there is not enough reliable evidence to suggest that Effexor should be prescribed as a first-line treatment for OCD. Researchers suggest that SSRIs are more effective at treating OCD symptoms, except possibly in “treatment-resistant OCD” cases.
Thus, SSRIs are the “preferred” OCD treatment at this time. Studies indicate that approximately 50% of people fail to respond to SSRIs (for anxiety, OCD, or depression), therefore, Effexor may be a viable alternative when other, more conventional medications have failed.
According to the National Collaborating Centre for Mental Health (UK), Effexor is not recommended as a first-line treatment for OCD – unless there is comorbidity (two separate conditions at one time). However, it may be beneficial for OCD when SSRIs have been unsuccessful or when other conditions, like depression or bipolar disorder, coexist with OCD.
Understand that finding the right OCD treatment will likely take time, effort, and persistence. In other words, you must be your own healthcare advocate. Your doctor may try different medications before you find the right one(s). Moreover, multiple medications may be prescribed to help you better manage your symptoms.
Keep in mind that each person responds differently to SSRIs and other OCD medications. This is primarily attributed to variances in body chemistries. Thus, finding medication(s) that work for you will likely involve some degree of trial and error.
You may respond to SSRIs or you may need to combine multiple OCD medications to receive relief. However, when SSRIs have failed and medication is still needed to wrangle your OCD symptoms back under control, alternative medications, like Effexor, may be prescribed. Also, the number of studies conducted on Effexor and other SNRIs and OCD has been severely limited. And, there is also the potential for more severe side effects and complications than with conventional, highly-researched medications, like SSRIs.
Thus, until more research is conducted, Effexor remains a second-line treatment for OCD.
Is There Anything I Should Be Aware of When Taking Effexor for OCD?
Yes, there are some things you should be aware of before and while taking Effexor for OCD, such as:
- Effexor is not generally recommended for children, under the age of 18 – except in certain situations.
- Anyone, regardless of age, may experience suicidal ideation (suicidal thoughts and attempts), while taking Effexor for OCD. However, the risks are higher in people, under the age of 24.
- It is important to monitor children, teens, and young adults, who are taking Effexor for their OCD symptoms, for side effects and complications.
- Pregnant women and women, who are breastfeeding, should weigh the pros and cons of taking Effexor for OCD with their doctors. Most pregnant women have taken Effexor for OCD – without any problem. If you are pregnant, you may be able to use exposure and response prevention (ERP) therapy to help reduce your Effexor usage during the first or last trimester of pregnancy.
- If you are experiencing “treatment-resistant OCD,” limited studies suggest that Effexor (venlafaxine) may be a safe and effective alternative to conventional SSRIs.
Should I Only Take Effexor When I Am Feeling Stressed or Overwhelmed?
No, however, that is a common myth.
Unlike typical anti-anxiety meds (only taken when you are anxious, stressed, or overwhelmed), most OCD medications, including Effexor, are designed to be taken daily to keep your serotonin levels at baseline (balanced). And, if possible, try not to miss a dose, however, if you do, take the medication as soon as possible. The good news is missing a dose every once in a while is unlikely to trigger or worsen your OCD symptoms. Your doctor may even suggest that you skip a dose or two a week to alleviate unpleasant side effects, such as sexual issues.
How Long After Beginning Effexor Can I Expect to See Improvement in My OCD Symptoms?
Effexor starts working almost immediately, however, it may be weeks before you experience “true relief” in your OCD symptoms (i.e., intrusive thoughts, urges, worries, mental images, doubt, fears, ritualistic behaviors, etc.). If you do not experience some degree of relief in your OCD symptoms within 8 weeks, contact your doctor.
Your doctor may suggest changing or “tweaking” your Effexor dosage or the frequency at which you take it. It is important, however, to talk to your doctor before you adjust the dosage. Keep in mind that most people do not experience a change in their thoughts, moods, feelings, or behavior within the first weeks of taking Effexor for OCD. However, after the second week, many OCD sufferers experience positive changes in these areas.
Will I Need to Stay on Effexor Forever?
It is unknown how long an OCD sufferer should take Effexor for his or her OCD symptoms.
Some people can be “weaned off” Effexor after 6-12 months of taking it. However, approximately 50% of OCD sufferers may need to stay on Effexor for years, or perhaps, forever. The risk of relapsing declines in people, who attend therapy sessions, in addition to taking medications, like SSRIs or SNRIs, like Effexor. However, if a medication is not working, it is important to gradually reduce the medication (possibly over several weeks or months) to prevent OCD withdrawal symptoms or an OCD relapse.
Attending cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and/or exposure and response prevention (ERP) therapy can help you retain control over your OCD symptoms as you “wean off” an OCD medication (i.e., Effexor). Keep in mind, however, that once you stop taking Effexor, your OCD symptoms may return within a few weeks – if no other medication is prescribed to offset your symptoms. The good news is most OCD sufferers will receive a good response once Effexor or another medication is restarted.
Will I Need to Combine Effexor with Other OCD Treatments to Effectively Manage My OCD Symptoms?
It is possible…
Most psychiatrists and therapists believe that combining CBT, ERP therapy, and/or ACT together, and implementing lifestyle changes (i.e., eating healthy foods, spending more time with friends and family, communing with nature, finding a hobby, getting plenty of good quality sleep, and following a regular exercise routine) natural remedies (i.e., CBD, vitamins and herbal supplements, etc.), alternative treatments (i.e., hypnosis and hypnotherapy, yoga, etc.), and self-help tools (i.e., Impulse Therapy, mindfulness meditation, books, apps, support groups, forums, etc.) into a treatment plan is the most effective approach to treating OCD.
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