Missed 1 Dose!

I have been on Effexor for 4 months, a relatively low dose of 112.5mg. I want to say that Effexor has helped restore me to my normal state and I really have no intention of going off of it anytime soon. When I first started I had a few side effects, mostly diarrhea.  I also see a counsellor to learn how to cope with triggers, I eat well and exercise.

I do not feel as though I suffer from PTSD anymore and I feel so normal that it's hard to tell I'm even on meds! 


Last night I stayed at my boyfriends place and had left my meds on my counter at home. I figured I would miss my bedtime Effexor and just take it first thing in the morning when I got home.


3 hours after the time I usually take my Effexor I was hit with what I would equate to a severe migraine. I couldn't lift my head off the pillow and I couldn't open my eyes. The pain in my head was so severe that it felt like my brain was being pushed out my ears. I had night sweats that soaked the mattress and caused me to be frozen under a heavy duvet. When the alarm went off at 5:30am I turned it off but could barely open my eyes. I had to get myself up and drive home to get ready for work but I wasn't sure I would be able to drive, the headache was so severe. I managed to get home but the sun, even through my sunglasses, hurt. 
The second I got home I took my Effexor and 3 Advil and within 20 minutes all was back to normal. Pain gone, felt good, had a shower, went to work.

I am now frightened for the day when my doctor says I don't need Effexor anymore. 

Is there any reason to come off of it? What would be wrong about just staying on it?
MountainGirl33 MountainGirl33
31-35, F
23 Responses Jun 9, 2010

I have been on Velaxafne 150mg since last November. My doctor prescribed it, ironically, as a last ditch effort to treat my insomnia and underlying depression. Prior to that, I had tried Sonata, Ambien, Ambien CR, Lexapro, Xanax, and Lorazepan. Seems like a lot, but spread out over 8 years and none of it effective.

When I did finally decide to try Effexor, after being desperate for a sleep solution where I have been averaging 3-5 hours of bad sleep for over 10 years while trying to be a single mom and work full time, I thought it was a miracle drug. I'd never felt better, happier, more normal.

The first week, I lost 8 pounds. By Christmas, I was down 23 pounds, the skinniest and best looking I had been since before my child was born. All wonderful, except that my doctor, who had prescribed the medication over the phone and without any caution, neglected to warn me of the interactive side effects of drinking, taking Xanax, or any other medication while on this.

When Christmas rolled around and I was trying to get through the holidays normally, I ended up having a terrible interaction. It turns out that the loss of appetite and weight wasn't just a bad side effect, it was a dangerous one.

Not recognizing that, not having been told anything at all about interactions, and continuing my lifestyle (with holiday parties, drinking wine as usual, taking Xanax to get me through so very stressful scenarios and to help me sleep), Christmas Eve I had a crisis. I had a major fight with my boyfriend and went home with my daughter.

She was picked up by her father for the next ten days, per our custody arrangement, at 8a Christmas morning. I took my Effexor, then took a Xanax, then went to bed. By the Friday after Christmas, I had been admitted to the ER in the hospital at 1a after my father called 911 after I began slurring and talking about wanting to go to sleep forever.

Apparently, at some point during the 36 hours leading up to the 911 call, I had stayed in bed by myself and refused to eat or do anything. In the last 6 hours before the call, I took a combined dose of 55 Xanax and Lorazepan, I an effort to help me sleep through the holidays. Unfortunately, I remember none of this, at all. And what I do know has been cobbled together from my text message history and the recounting of various conversations with my father and now ex boyfriend. I was admitted to the psychiatric unit for five days, released into my parents care on NYE.

Speaking at great length to the in house psychiatrist, as well as the out patient doctors, I suffered from retrograde amnesia from the overdose of Benzos. The extreme weight loss was not only a bad side effect, but it was a dangerous side effect. Apparently, I am one of the 5% who should have been taken off it immediately. All other medications should have been ceased immediately, and I should have been given education as to what to look for as warning signs while starting the new medication. None of that happened. Days after my release, I then lost custody of my child for 45 days, not because of anything done to her but because the DCS are not trained to understand medical interactions nor did anyone at the time understand what happened. To them, it appeared I had tried to kill myself, and I was therefore a potential danger to my child until they understood.

By two weeks out, we figured out what had happened, it is well documented - all over the Internet and in medical forums, articles, etc - that Effexor is a dangerous drug to start, and that are many many dangerous interactions that can happen. Once I lost 25 pounds, my system was compromised and I was that much more susceptible to the effects. You know those commercials that say "stop taking this drug if you experience suicidal thoughts" etc? That was me, but the crisis hit so hard and fast, and I was so far under, I had no idea what was happening when it hit me.

Please note. I am a very responsible mother, manager, owner of a consulting firm where my income is in excess of $140k a year. I live in a very beautiful and wealthy town on the east coast, and by all accounts, have a wonderful life and close friends. Suicide was never in the cards, and to have had this happen to me has shaken not only me to the core, but my immediate family, closest friends and my child. Whom I have had to lie to in explaining why mommy was in the hospital for five days.

It's been six months now, and I am still trying to get off this medication, to no avail. My withdrawal symptoms are horrible. Night sweats. Migraines. Sinus infections that last 24 hours. Irritability. Manic behavior. Lethargy. And oh yeah, horrible insomnia. I may have resigned myself to never getting more than 4 hours of sleep a night for the rest of my life. But I cannot subject my child to me like this.

My only advice is this: do not take this drug if there is any other option. And if you must, educate yourself, then educate yourself some more, then drill your doctor down to name sure that they know to monitor you and that they know the warning signs.

Mine wrote the script then left me to my own devices. If my father hadn't called 911 when he did, we all know I would have died.
Sorry, I know it's a long story, but if it helps someone else, it's worth it to have read it.


I feel a little better knowing that I am not the only one who has a difficult time when either late or missing a dose of Effexor Xr. I have been on Effexor Xr for 3 years and at my current dose of 150 mg for about 6 months.

I never was a morning person, and thought it was just me being "lazy" as to why I would sleep late or ALL DAY! It was starting to create a problem with work and social life. Now I think that the Effexor XR (I take generic) isn't lasting 24 hrs and I start to go through withdrawal before my next dose. I tend to have vivid dreams and wake up soaking wet from sweating. Even though I know I should get up, I just can't. My friends and family don't understand which makes for strained relationships. When I do take the Effexor XR with my other medication I feel the most "normal" I could be...which is a wonderful feeling, which is why I am afraid of switching to another antidepressant. I was wondering if splitting my dose (am and pm) would help with consistency. Does anyone take Effexor XR am and pm? Anyone else go into withdrawal sooner than 24 hours?

Hi. I am on Venlafaxine, 37.5mg twice a day, one morning / one evening. I missed my morning dose today and I have felt disorientated and groggy, didn't realise it was a missed dose and thought I just had neck ache (stupid woman!!). I am glad I am not alone in feeling cruddy when a dose is missed, it can be quite scary. I am waiting for my evening dose to 'kick in' and hopefully feel better soon. Thank you everyone for this thread.

Been taking Effexor XR for about 7 years now. It has improved my situation greatly, but whenever I miss a dose I have bad dreams, night sweat, and I can barely get out of bed the morning after. Yesterday I stayed at a friend's house and forgot the med at home. Today I felt weak, confused and mostly I felt like my anxiety was back, which is probably due to both forgetting the dose and the fact that I've had a rough couple of weeks.

My insurance got messed up and I missed 2 nights, I take 3 37.5's. Extreme night sweats and awful nightmares. I was waking up every 30 min or so, tucking the sheet around me to absorb some sweat and then going right back into the nightmare. I just started a new job & I'm training. The nausea started today. I left at lunch to try to get the insurance figured out, threw up in my car, barely made it home. More throwing up at home & cleared my bowels. Got on the phone & got things figured but she said it can take 24 hrs. Called the rx anyway, no go. Went to bed, terrible nightmare, sweating and fever. Called again after an hour and a half, she said come in, so I went over there (3 min from my apt), it wasnt fixed! I was so sick by that point I begged for a couple days dose, got it, came home and took my three. Feeling a bit better but its a placebo effect, I'm sure. Just hoping im ok in the morning, I have my insurance test! Big irony there! I suppose it's different for everyone, how quick the recovery from missed doses is..

I realized I didn't put my story in the place I originally intended :/

Ive Been on effexor 150 mg for about 8 months. The first month I took it I was exhausted all day long and often had to take naps which is very unusual for myself. After that I started feeling great but kind of manic as in my highs were very extreme. But since has kept me on a nice positive productive mood. Missed my first dose last night and had some awful symptoms all day. Was lightheaded, nauseous and felt like I was going to pass out at any moment. I thought I was coming down with some sort of infection and didn't contribute it to missing a dose until doing some research on it. This is also the first time I've been on any antianxiety/depression medication. Just took today's dose and hoping effects subside soon

Dealing with this right now too :(
Last time it happened to me it took about 24hrs to feel better.
I am currently on 300mg so don't know if that makes a difference.
Hope you are feeling better now!!

I am on 300mg of Effexor. It has helped me significantly over the last 4-6 months.

I do experience minor side effects like excessive sweating and my eating habits can be hit or miss.

On the rare occasion that I miss a dose, I find I have strong reactions. I experience what I can best describe as a blurry mind and eyes or jolting brain sensations. They cause me to become dizzy, slightly disoriented and is very hard to focus. It can some times feel like an out of body experience.

Overall I am very pleased with how this medication has worked for me. I am not worried about the withdrawals when I no longer need the medication. They make Effexor in a lot of doses, which would make it easier and not as big of shock to my body to taper off when the time comes.

I take 150mg a day and forgot yesterday, meaning I feel really sick today.

It's a great drug but it's not advised to take during pregnancy as I am sure you all know the serious effects it has on the body.

As I am also on a contraceptive pill I use the iPhone app 'my OC' which discreetly reminds me to take my pills every day. I couldn't live without it! I recommend it to everyone.

Thanks for the recommendation!
Current having withdrawals from forgetting yesterday!!! Gah!!

I have taken effexor x5 150 for a couple months now after taking Citalopram 20-40 mg for 10 years to deal with GAD/Panic Attacks. Missed my dose yesterday morning and felt it about 4 hours later with minor "jolts to the electrical system". No biggie, experienced before with celexa. Was going to take when I got home but my son had an interview with college and got accepted so we rushed to take him out to eat. Got home and thought "I'll just take normal dose in morning" as the worst would probably be more electrical jolts.

HOLY MOSES biggest mistake of my life. Had a incredibly vivid dream of killing people with a motorcycle gang (what the hell?). Woke up in morning feeling like a vise was cranked around my head. Body felt like I had sea legs when I walked . Could not eat anything due to nausea.

Took a 2 hour nap 4 hours later and felt somewhat better but still had panic feeling of what if this isn't from missing my meds. Got home 9 hours later, cut the grass and finally my stomach is growling and I am hungry. THANK GOD!!!

Don't get me wrong, the medicine is working great for Obsessive thoughts related to anxiety (health anxiety) and panic. I remember thinking this past week of how well I feel. However, I will NEVER, EVER skip an entire day of a dose. I know I can make it through the symptoms but why would I want to:-)

I've been on Effexor XR for about 3 years now for generalized anxiety disorder. I rarely miss a dose but did last night and had night sweats, horrible dreams, etc. I feel very confused all day long despite remembering to take dose with lunch. Here's the difference between being on Effexor Xr and not being on it. Before I was on it, I worried, what if I'm in a foreign country and can't get it? What if I have to have surgery and they forget to give it to me? And now being on it, those concerns are dimmed considerably. It takes away debilitating worry. So it's worth it. I think. Don't ask me. I feel confused. Ha!

I'm trying to be funny. I really has to dimmed the obsessive worrying. I know you have to take every day one day at a time and it helps with that so I'm not worrying to the point of tears -- what if I miss a dose and can't get my hands on one?

I have missed doses twice in 8 years and the first time I felt like I had the flu and was really nauseated. It took about 3 hours before the symptoms disappeared and I felt great. I took it 7 hours after my usual time and I had a panic attack and a migraine. I have an after school babysitting job and was going through the attack with the kids in the car and I laid down once I got there. I don't know how to describe the feelings other then my body felt weird and I was scared. It took 3 to 4 hours before I was feeling better. I am on 150 mg. a day and I took my medication a little later this morning than usual as I have a work meeting and I don't want to feel like that again. I know it hasn't been 24 hours and I will probably be really tired but it is better than feeling like you are going out of your mind and feeling things you shouldn't. This medication changed my life for the better and my doctor said you can never go off of it because your life is way to stressful.

I have been taking Effexor 75mg for about 6 months now and honestly I could not be happier. My grades have gone up, I'm no longer constantly worried about strange unordinary things, and my social anxiety is at a complete stop.

But I also have seen the dark side of this drug. The first time I missed a dose it was because I was drinking with a friend and just plain forgot. The next morning I could not even open my eyes. I can honestly say it was the worst pain in my life and I blamed it on the alcohol. (Only had one beer so I was pretty confused). I just thought it was a weird side effect that had to do with drinking. Then I realized I forgot to take the pill the day before.
Now I sit here again 3 months later with that same migraine of death. It is so bad that I just took the pill (it's 2:30am) and 3 tylenols. It's been 30 minutes and so far no good.

Tldr: missing one dose of this drug has AWFUL AWFUL consequences and there is nothing worse then the pain in my head when that happens. Literally the worst pain for this long of a time. Why do they not fix this problemmmmm.

Loved reading everyone's responses. You would think after being on it for 12 years I would learn not to miss doses. Missed two doses in a row and I am miserable! Nightmares, diarhea, lethargy are just some of what I'm feeling today! I won't do that again. Effexor has saved my life and I most likely will be on it for my entire life. It works for me and I won't EVER miss a dose because I'm too lazy to go downstairs to get it!

My psychiatrist told me there is no reason to ever stop taking it as its the only rx that has ever treatedy depression and anxiety. I have tried them all and plan to take effexor until I die or it stops working and I need to take something else.

Missed doses are the worst. The side effects are what remind me that I didn't take it. Strange vivid dreams accompanied by night sweats.

Remember, no pill cures depression, PTSD, anxiety etc. They only treat the symptoms these diseases cause. Once you're off, it rears it's ugly head. If your problem is situational, you can probably get better through counseling. Unfortunately my depression and anxiety episodes would come out of no where to the point I would be crying for no reason and unable to stop.

Good luck - too much bad press about effexor out there - too much stigmatizing about mental illness. Just keep doing what works for you. Personally effexor has saved my life and has help me feel like "me" - I have no other negative side effects than those that come with a missed dose and in the grand vision of things - no big deal when compared to the consequences.

I've been on venlafaxine ex 150 mg per day for 6 years.

My doctors don't want me to get off this **** and if you're asking yourself why stop it's because it's not making enough that you'r on Effexor . Stoping by yourself is crazy , i lose my job , barelly lose my boyfriend and had to go away of my friends and family to do that .

I having been taking Effexor for about 2 months now and really have taught myself a lesson on missing doses.Effexor is the first med I have had to take in the morning and night and I have missed 2 morning does in the last couple of weeks because my morning schedule was messed up. With the missed doses I have gotten terrible headaches, nausea, and really bad dizziness. What a mess!! I have to figure out how to remember my doses or I am doomed to suffer.....

Don't worry about the time when you decide to get off of the medication. Just know that your doctor should wean you off of Effexor VERY slowly. Mine told me she would wean me off over a course of 6 to 8 months. I too have experienced nausea from missing a dose and it just teaches me to be careful not to miss if possible.

I, unfortunately, have experienced missed dose side effects many times. I used to take 150mg daily, in the am. I've been on it for several years. If my morning schedule is disrupted in any way... i can forget. Usually I can tell a missed dose within 3-4 hours. Nausea and headache sets in.

Yesterday, I woke up in a hurry. I had wine the night before and assumed my slight headache was from that. I am training for the Komen 3 day walk. We walked 15 miles. When i got home, i was tired and sore. As the day went on my symptoms got worse. Stomache irritability, severe headache, nausea. I also started my period that morn and was attributing some of the stomache disturbance to that. I was a mess. I never attributed it to not taking my meds!! I went to bed about 9pm tossed and turned all night, sweating profusely, migraine pain, nausea. This morn I crawled out of bed with nausea, diarrhea, fever, and all the rest. I went to take my meds and AH HA I had missed yesterday's dose. I am still suffering. It will take at least 3 hours to feel better, sometimes longer... I really want to try to get off this stuff!

Thanks all of you for sharing your Effexor Story. It's so neat to be able to hit a button on my laptop and read abt 35 other people in my same boat, very encouraging. I definitely see that some of us are more sensitive to the side effects. I didn't get the dry mouth that much, but the tense jaw muscle feeling is very evident...not a big deal though, not like it effects my speech or anything. I feel the jaw clenching most about 40 minutes after I take it. I'm wondering if the Effexor is making me feel tired. I'm exhausted all day and it makes me feel depressed. I have no energy and I have 2 active kids to keep up with. My husband thinks I should switch, but I disagree right now. That could change. As far as the missed dose goes, I miss probably one dose a week and have NO side effects at all! BUT....LOL...UGH in my opinion, it's the harshest pill on my stomach I've ever taken. It makes me feel like my stomach is going to contract by itself and throw up if I let my belly stay EMPTY for too long, it's weird and ammoying. <br />
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Again, thanks all for sharing. I'll be back to read up more on all of our further experiences with Effexor Xr.

Thanks tb9782.<br />
<br />
That's a great idea actually. I have been carrying the huge pill bottles around with me ever since but it makes waaay more sense to just carry one or two pills!! Nice to hear Effexor had some positive effects on your depression. I am quite happy with how it has helped me :)<br />
Take care.

Effexor works different for everyone. I've been on it for over 3 years, and even had my dosage adjusted up, then back down with none of the horrid side effects you had--(and I'm well aware of). In my case, I travel alot and have a varied schedule--as such the times i take it in the morning can vary by several hours. I personally haven't had a problem with doing this, but you appear to be more sensitive to the withdrawl effects. One thing my doctor suggested to me is to always keep at least 1 pill in my wallet---ie. it's ALWAYS with me. Since I always travel with a laptop bag, the meds are always there. I would suggest you do the same--stash some in your purse, with your Driver's License, etc. Since you've unfortunately experienced the withdrawl, that will motivate you to become religious about making sure there is a pill always with you.<br />
As to its effectiveness, it has helped me. It helped "moderately" with my depression at 150mg for almost 3 years, but still didn't seem quite enough. For me, the magic dose is 225mg, which seems to help remove even my social anxiety. I just feel "normal"--not drugged out or disconnected. Again, everyone has different reactions--you just have to judge how it is working for you. Good luck....

Thanks roxygirl534 for sharing your story. I am in therapy along with the meds and don't particularly want to be on the meds forever. <br />
That night of missed dose scared me but I'm thinking of waiting to see if it happens again if I ever miss another dose. I have read so much that I am prepared for a horrible withdrawal when the time comes for me to be off of Effexor, I was just wondering if it is actually harmful to your body to stay on Effexor for years and years if you are feeling good on it? In essence, why come off it if it's not hurting you? <br />
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Thanks Twillback for your advice also!<br />
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Have a great days guys :)

I've been reading a lot that effexor can really mess with you if you skip a dose. however i unintentionally miss my doses from time to time and its never been a problem for me. i never really ever go more than 24 after the missed dose. i started effexor in the fall for my major depression. my doc just recently, like 2 months ago, tried taking me off effexor and putting me on lexapro. bad idea because i slipped back into a major depressive episode. it wasnt done cold turkey either, it was a slow process. i almost immediately asked to be put back on the effexor so ive been on about 75 mg since then in addition to 20 mg of lexapro. last week i just got off the lexapro and he has me on luvox for my ocd in addition to the effexor for my depression.<br />
ive always been told meds are a temporarily solution to help you be able to work through your probblems psychologically in therapy. so if your going to therapy and doing work in there, this should lessen your symptoms. in time, you may find that you dont need to be on as high of a dose as you are reqiured to be on now because you could be feeling better. this usually isnt done immediately though, docs usually wait several months after you are feeling somewhat/significantly better to lower the dose. sometimes, docs may even believe that people can eventually (in years and years and years in the longrun) function without any meds. just dont become dependent on the meds, the real change comes from within you

Effexor is great, if it works, but it can be a ***** to get off of or if you miss a dose. It has some pretty wicked withdraw symptoms and from your explanation, missing one dose really kicked your ***. I would almost talk to your doctor about it. One thing about this drug, just stopping cold turkey is generally a very bad idea. If your doctor is smart, when it comes time for you to go off of it, you will be tapered down a small amount at a time so your body can get used to lower and lower doses without cutting everything off at once.