Venlafaxine Alternatives: Medications Similar To Effexor

Last Updated: December 19, 2019

Authored by Nena Messina, Ph.D.

There are many drugs similar to Effexor that can be used for treating depression and anxiety, such as Pristiq, Zoloft, Lexapro, and Prozac, but they work in different ways. These medications may be used for patients who cannot afford Effexor or have contraindications to its use. In some cases, alternatives to venlafaxine may have fewer side effects. Sometimes natural alternatives to venlafaxine can be safer and have fewer side effects. A healthcare provider may find a suitable alternative to Effexor. Choosing an alternative to Effexor without a doctor’s advice may be dangerous to health.

Effexor vs. Pristiq (Desvenlafaxine)

Venlafaxine and Pristiq are both grouped in a class of medications called SNRIs (selective serotonin and norepinephrine reuptake inhibitors). Both are approved to treat depression. They are available as extended-release oral tablets.

  • Comparing pharmacological uses of desvenlafaxine vs. venlafaxine, Effexor is used for treating major depressive disorders, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, and panic disorder. Desvenlafaxine is used only for major depressive disorders. However, venlafaxine cost is lower than the price of Pristiq.
  • There is a difference between Effexor and Pristiq in how they are metabolized. Pristiq is metabolized by the CYP3A4 hepatic enzyme, while Effexor is processed by the CYP2D6 enzyme.
  • The half-life of Effexor XR and Pristiq is about 12 hours.
  • Both medications have similar adverse reactions such as somnolence, constipation, and erectile dysfunction.
  • Both drugs are pregnancy category C, which means that they may have adverse effects on the fetus. Taking Pristiq as well as venlafaxine while pregnant requires a doctor’s consultation to avoid possible adverse reactions.
  • When comparing the use of Pristiq vs. Effexor in hepatic and renal patients, Pristiq can be safely used after monitoring its dose, while Effexor doses should be adjusted for those patients.

Effexor vs. Cymbalta (Duloxetine)

Both are effective SNRI medications that can treat depression. When comparing Cymbalta vs. Effexor for anxiety, both are effective for relieving anxiety disorders. However, Cymbalta can also treat diabetic neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. Venlafaxine can be used for insomnia, but Cymbalta can not. Here are some more differences and similarities between these drugs:

  • When comparing Cymbalta vs. Effexor for sedation, venlafaxine is preferred for insomnia because it is more sedative than Cymbalta.
  • Both have similar half-lives for around 12 hours.
  • Both drugs have similar adverse reactions such as nausea, constipation, and dry mouth. The difference between Cymbalta and Effexor is that Cymbalta doesn’t cause erectile dysfunction.
  • Both medications may cause hypertension.
  • The two drugs may cause a high risk of suicidal thoughts and behaviors in teenagers.
  • Both are pregnancy category C drugs. It is recommended to consult a doctor before taking these medications during pregnancy.
  • When comparing duloxetine vs. venlafaxine, Cymbalta must be avoided for patients with hepatic and renal problems while venlafaxine may be used after dose monitoring.

alternative medication to effexor

Effexor vs. Zoloft (Sertraline)

Both are used for treating social anxiety disorder and panic disorder. They are also used for treating post-traumatic stress disorder and premenstrual dysphoric disorder.

What is the difference between Zoloft and Effexor? Zoloft is an antidepressant drug as well as venlafaxine, but Zoloft works differently:

  • Sertraline is effective for bulimia and binge eating disorder.
  • When comparing the mechanism of action of Effexor vs. Zoloft, sertraline is a selective serotonin reuptake inhibitor (SSRI) that results in increasing serotonin in the brain. But venlafaxine increases both serotonin and norepinephrine centrally.
  • Zoloft half-life is twice longer – about 26 hours.
  • Most side effects of venlafaxine are similar to Zoloft, but sertraline may cause anorgasmia, agitation, shaking, and diarrhea.
  • Venlafaxine causes more sleepiness than Zoloft. It is not advised to take venlafaxine while driving or operating heavy machinery. Therefore, the healthcare provider may advise taking Zoloft instead of venlafaxine as it causes less sleepiness.
  • Both are pregnancy category C medicines.

Effexor vs. Lexapro (Escitalopram)

Escitalopram can treat depression and anxiety as Effexor. Although they treat similar conditions, the difference between Lexapro and Effexor is in how they work:

  • Lexapro is not effective in treating social anxiety disorder and panic disorder. According to a study published in the Journal of the U.S. National Library of Medicine, when both medications are rapidly titrated to maximum recommended doses, Lexapro is at least as effective in treating major depressive disorders as Effexor XR and significantly well tolerated.
  • Lexapro is a selective serotonin reuptake inhibitor, but Effexor is SNRI.
  • Lexapro half-life is sometimes three times longer – about 27-33 hours.
  • When comparing Effexor vs. Lexapro side effects, escitalopram is less likely to cause adverse effects than Effexor. However, Lexapro may cause agitation, shaking, and diarrhea.
  • Both are pregnancy category С drugs.
  • It is recommended to avoid taking Lexapro in patients who have hepatic or renal problems.

compare effexor alternatives

Effexor vs. Wellbutrin (Bupropion HCl)

When comparing Effexor vs. Wellbutrin for treating depression, both medications are effective in relieving depression symptoms. The following are some more differences and similarities between these drugs:

  • Bupropion can be used for treating attention deficit hyperactivity disorder (ADHD) symptoms. It can also be used to suppress appetite and helps in quitting smoking.
  • Wellbutrin is a norepinephrine-dopamine reuptake inhibitor while venlafaxine HCl ER inhibits the reuptake of norepinephrine and serotonin.
  • Wellbutrin is not effective for anxiety and panic disorder.
  • Wellbutrin half-life is three times longer – about 33 to 37 hours.
  • Wellbutrin has a higher risk of causing seizures than venlafaxine, especially while taking it with alcohol.
  • Bupropion has more favorable sexual side effects than Effexor.
  • Bupropion has some stimulant effects, but venlafaxine has sedative activities.
  • Wellbutrin has a  pregnancy category B, but venlafaxine has a pregnancy category C.

Effexor vs. Prozac (Fluoxetine)

However, both are used for treating depression and anxiety, they may differ in some properties. The following are some more similarities and differences between these medications:

  • Prozac is a selective serotonin reuptake inhibitor (SSRI), while the Effexor class of drug is SNRI.
  • Prozac is more energizing than venlafaxine. It is not recommended to use Prozac for patients who have trouble sleeping.
  • There is a significant difference between Prozac and Effexor in their half-lives. Prozac half time is about 3 days. It takes about 1 to 2 weeks for its effects to appear.
  • Comparing the safety of Effexor vs Prozac for patients with heart problems, it is preferred to use fluoxetine for patients who have cardiac problems than Effexor. Effexor may cause tachycardia and hypertension. As a result, venlafaxine is not preferred to be used in cardiac patients.
  • There is a connection between venlafaxine and weight gain. Therefore, a doctor may decide that it would be more sensible to use fluoxetine for patients with excess weight, as it may cause significant weight loss.
  • Urticaria and angioedema are common adverse reactions of Prozac. Effexor doesn’t cause these effects.
  • Both medications are pregnancy category C.

what effexor alternative to choose

Effexor vs. Paxil (Paroxetine)

Both medications are good for treating depression and anxiety. However, they can have some similar and different properties such as:

  • When comparing Paxil vs. Effexor for treating depression, venlafaxine provides more immediate symptom relief than Paxil.
  • Paroxetine is a selective serotonin reuptake inhibitor (SSRI).
  • Both medications undergo ‎hepatic‎ metabolism by CYP2D6.
  • These medications have different half-lives. Paroxetine half-life is about 21 hours.
  • About 64% of Paxil dose is really excreted, while 87% of the Effexor dose is excreted in the urine.
  • Effexor has a higher rate of side effects such as nausea and constipation than Paxil.
  • Paxil is pregnancy category D. Using Paxil during pregnancy may increase the risk of fetal heart defects.

Effexor vs. Celexa (Citalopram)

Although Celexa and Effexor are used for treating depression and anxiety, they can have some similar and different properties such as:

  • Citalopram acts primarily on serotonin reuptake channels (SSRI).
  • The half-life of the citalopram is about 35 hours.
  • When comparing Celexa vs. Effexor regarding possible adverse reactions, Celexa is less drowsy than Effexor.
  • It is not preferred to use both medications for people who have heart impairments. According to the U.S. Food and Drug Administration, high doses of Celexa can cause serious abnormalities in cardiac electrical activity.
  • Both medications are pregnancy category C.

better effexor alternatives

Effexor vs. Trintellix (Vortioxetine)

Both are used to treat major depressive disorders but can differ in how they work. Here are some similarities and differences between the two drugs:

  • Trintellix is beneficial for improving memory than Effexor.
  • Trintellix is a selective serotonin reuptake inhibitor (SSRI).
  • Both have different half-lives. Vortioxetine half-life is about 66 hours. It may take several weeks before appearing its effects.
  • The side effects of both medications are similar, but Trintellix may cause diarrhea, gas, and itching.
  • Vortioxetine is known to cause less sexual adverse reactions than Effexor. As a result, it is recommended to use Trintellix for patients who suffer from loss of libido with other antidepressants.
  • Both medications are pregnancy category С.

Effexor vs. Xanax (Alprazolam)

Venlafaxine and Xanax may be used in relieving generalized anxiety disorder associated with depression and panic disorder. Although they treat similar conditions, there is a difference in how they work:

  • Xanax works by binding to gamma-aminobutyric acid (GABA) receptors in the brain.
  • Both have nearly similar half-lives. Xanax half-life is about 12 to 15 hours.
  • Side effects of Xanax are different from venlafaxine and include stuffy nose, diarrhea, and swelling in the extremities.
  • Xanax is pregnancy category D. The use of Xanax during pregnancy is associated with congenital abnormalities.
  • It is not recommended to take both medications for hepatic patients.

Natural Alternatives To Effexor

What natural alternatives can one take instead of Effexor? There are some natural alternatives to Effexor that may help depressed patients without dangerous side effects of venlafaxine. Natural venlafaxine alternatives aren’t a replacement for depression treatment. To ensure safe use of natural alternatives, it is recommended to consult a medical provider first. The following are some natural alternatives for venlafaxine.

S-Adenosyl- L-Methionine (SAMe)

SAMe is a dietary supplement available in the U.S. market.  It is safe and effective in treating depression, but it is not approved by the Food and Drug Administration (FDA) yet.

Omega-3 Fatty Acids

Omega-3 supplements are being researched for the treatment of depression, mood disorders, and depressive symptoms in people with bipolar disorder.

Ginkgo Biloba

According to the U.S. National Library of Medicine, Ginkgo Biloba extract is an adjunctive treatment that can effectively improve symptoms of depression. It enhances blood circulation and oxygen supply to the brain.

natural effexor alternatives

St. John’s Wort

It is a herbal supplement that is used for treating mild to moderate depression but is not approved by the Food and Drug Administration (FDA) in the U.S.


The benefits of saffron for treating depression are well documented. But it may cause dangerous side effects if taken in high doses. It is important to consult a healthcare provider before taking saffron, to avoid the risk of dangerous effects.


It is an amino acid that can be found in green and black tea. L-theanine has several beneficial effects in patients with major depressive disorders for treating depression, sleep disturbance, and anxiety.


Sceletium is used for relieving stress and treating anxiety and depression. Sceletium is a selective serotonin reuptake inhibitor (SSRI) with inhibition of phosphodiesterase-4(PDE4). The combination of SSRIs with PDE4 inhibitor has synergistic therapeutic potential in central nervous system disorders by providing higher symptomatic efficacy and wider therapeutic benefit than either as a medication on its own.


Regular use of turmeric can increase dopamine and serotonin levels in the blood. It can result in greater feelings of happiness for patients who suffer from depression. Turmeric is well-tolerated and efficacious among depressed patients.

What Alternative To Effexor Should One Choose?

Lexapro is an effective alternative to venlafaxine with less adverse reactions. There are also several alternatives to Effexor XR that can be used with better efficacy and fewer side effects, such as turmeric, sceletium, and ginkgo biloba. However, it is recommended to consult a doctor to choose the most suitable alternative as the adverse and allergic reactions are still possible. Before resorting to venlafaxine uses or the use of its alternatives it’s crucial to consult a medical specialist. Venlafaxine withdrawal symptoms may appear after stopping its use suddenly or after switching to alternative medication without a doctor’s approval. It would be essential to look for a suitable treatment plan to start recovering in such a case. Finding a rehab facility is highly recommended to accelerate the recovery process.

Page Sources

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  2. Hidese S, Ota M, Wakabayashi C, Noda T, Ozawa H, Okubo T, Kunugi H. Effects of chronic l-theanine administration in patients with major depressive disorder: an open-label study. Acta Neuropsychiatrica. 2017; 29(2): 72-79. doi: 10.1017/neu.2016.33.
  3. Clarification of dosing and warning recommendations for Celexa. The US Food & Drug Administration. 2016.
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  6. Bielski RJ, Ventura D, Chang CC. A double-blind comparison of escitalopram and venlafaxine extended release in the treatment of major depressive disorder. The Journal of Clinical Psychiatry. 2004; 65(9): 1190-6.
  7. Tuman TC, Tuman B, Polat M, Çakır U. Urticaria and Angioedema Associated with Fluoxetine. Clinical Psychopharmacology and Neuroscience. 2017; 15(4): 418–419. doi:10.9758/cpn.2017.15.4.418.
  8. Einarson A. Paroxetine use in pregnancy and increased risk of heart defects: Evaluating the evidence. Canadian Family Physician. 2010; 56(8): 767–768.
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Published on: November 29th, 2019

Updated on: December 19th, 2019

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.


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