Venlafaxine and alcohol: risks and side effects

If you’ve been prescribed venlafaxine or Effexor XR, you may wonder if it’s okay to drink alcohol while taking it. Learn about the side effects and risks of drinking that glass of wine when taking this antidepressant.

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Venlafaxine, also known by its brand name, Effexor XR, is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. Serotonin and norepinephrine are neurotransmitters found in the nervous system and brain. These neurotransmitters send messages to your brain cells that help to control your mood. Low levels of these neurotransmitters contribute to feelings of depression and anxiety. Venlafaxine balances the levels of serotonin and norepinephrine to improve your mood (Singh, 2020). 

This medication is approved by the U.S. Food and Drug Administration (FDA) to treat major depressive disorder (MDD), anxiety disorder, social anxiety disorder, and panic disorder. Some healthcare professionals use venlafaxine to treat attention deficit disorder (ADD), migraine prevention, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), complex pain syndromes, fibromyalgia, diabetic neuropathy, premenstrual dysphoric disorder (PMDD), and hot flashes in menopausal women (Singh, 2020).

Venlafaxine comes in immediate-release and extended-release tablets. The brand name version, Effexor XR, only comes as an extended-release capsule (NAMI, 2020).

All antidepressant drugs have side effects. Some of the common side effects of venlafaxine start when you first take it but go away as you get used to the medication (NAMI, 2020).

Common side effects

Here are some of the most common side effects of venlafaxine (NAMI, 2020):

• Constipation 

• Dizziness

• Dry mouth

• Loss of appetite

• Nausea

• Sweating

• Trouble sleeping

• Weakness

Some adverse effects of venlafaxine may not go away over time. You may want to seek medical advice about lowering your dose or changing your medication if you have persistent side effects of venlafaxine. Some side effects that are more likely to be ongoing include loss of libido, erectile dysfunction, or an inability to orgasm. Some people develop high blood pressure when taking venlafaxine (NAMI, 2020).

Serious side effects

Serious side effects from venlafaxine can occur. If you experience any of these symptoms, call your healthcare provider immediately or call 911 (Wyeth Pharmaceuticals, 2018)

• Abnormal bleeding, including coughing up blood, nosebleeds, bruising easily and often, or blood in your stool

• High blood pressure with headache or shortness of breath

• Hyponatremia or low sodium levels with fainting, headache, feeling weak, or seizures

• Lung problems like pneumonia with chest pain, fever, cough, and shortness of breath

Dangerous side effects

In rare cases, dangerous side effects are possible. These include (Wyeth Pharmaceuticals, 2018):

• Seizures

• Serotonin syndrome, a condition in which your serotonin levels are too high. You can have shakiness, fever, diarrhea, rapid heartbeat, anxiety, and seizures.

• Suicidal thoughts and behaviors: Effexor and venlafaxine have a black box warning from the FDA for this potentially serious side effect in children, teens, and young adults under 24 (FDA, 2012).

Alcohol interacts with many medications, including antidepressants. It is always best to speak to your healthcare provider to see if drinking alcohol when taking venlafaxine is appropriate for you. 

Venlafaxine and alcohol each have side effects, and these can worsen when you combine them. If you experience some of the side effects of venlafaxine, you may not be able to tolerate the combined impact of alcohol and venlafaxine (NAMI, nd). 

There are two main reasons it’s not a good idea to mix alcohol and venlafaxine.

1. Increased side effects

Alcohol and venlafaxine have similar side effects of dizziness, drowsiness, and weakness. Using them together intensifies their side effects.

Some of the side effects of mixing alcohol and venlafaxine include (Wyeth Pharmaceuticals, 2018):

• Anxiety

• Blackouts or short-term memory loss

• Confusion

• Delayed reaction times

• Dizziness

• Drowsiness

• Impairment

• Poor muscle coordination

• Problems moving your body

Alcohol can cause erectile dysfunction, and venlafaxine has sexual dysfunction side effects, including erectile dysfunction (ED). If you are a person who struggles with this issue, you may want to stay away from alcohol when taking venlafaxine, as your risk for ED significantly increases (Wyeth Pharmaceuticals, 2018).

2. Decreased effectiveness

Drinking alcohol when you take venlafaxine decreases the effectiveness of your antidepressant medication (Wyeth Pharmaceuticals, 2018).

Mixing alcohol and venlafaxine can create severe and even life-threatening side effects.

Venlafaxine is used to help treat mental health conditions. Alcohol decreases venlafaxine’s effectiveness in treating your symptoms, potentially worsening your mental health or preventing improvement. You may feel intense anxiety, paranoia, deep sadness, and extreme mood swings (Wyeth Pharmaceuticals, 2018). 

The liver metabolizes both alcohol and venlafaxine. You raise your risk of liver damage just from drinking alcohol. That risk increases when combining your medication and alcohol. Venlafaxine also raises blood pressure in some individuals and can create severe heart-related problems when combined with alcohol (Wyeth Pharmaceuticals, 2018)l.

If you drink alcohol when taking your dose of venlafaxine, you dramatically increase your risk of bleeding. You may experience nosebleeds and frequent bruising. Internal bleeding in your stomach or brain is also a possibility when combining venlafaxine with alcohol (Wyeth Pharmaceuticals, 2018). 

If you or your loved one has any of these symptoms, call your healthcare provider or 911 immediately. 

If you or a loved one want help with alcohol dependency, please call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-HELP.

If your healthcare provider prescribes venlafaxine, tell them about any typical alcohol use you may have. They may make recommendations on how much alcohol you can have based on your physical and mental history and health (NIAAA, 2014)

Follow your healthcare provider’s instructions while on venlafaxine to ensure a safe road to recovery.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

July 12, 2021

Written by

Tobi Ash, MBA, RN, BSN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.