Does Effexor treat PTSD? (+2 proofs)

In this article, we will discuss if Effexor can be used for the treatment of post-traumatic stress disorder (PTSD). PTSD is a condition characterized by traumatic memory intrusions, avoidance and numbing behaviour, and hyperarousal.

Does Effexor treat PTSD?

Yes, Effexor treats PTSD. It may lessen hyperarousal, avoidance/numbing, and other core symptoms of PTSD by blocking the reuptake of serotonin and norepinephrine. Effexor has shown effectiveness in the short-term and chronic treatment of PTSD (1).

PTSD is often seen in patients with comorbid major depressive disorder (MDD) 50% of the time. Because Effexor is prescribed for MDD, therefore, it can also be beneficial for the treatment of PTSD. However, such treatment will be considered as an off-label use of Effexor for PTSD.

The Food and Drug Administration (FDA) has approved the use of sertraline and paroxetine for PTSD. Sertraline and paroxetine belong to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants. Whereas, Effexor is a selective serotonin-norepinephrine reuptake inhibitor (SNRI).

Effexor is recommended as a monotherapy for PTSD in the Clinical Practice Guidelines for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder for patients who are unable to engage or access trauma-focused therapy. The usual dose of Effexor for PTSD is 75 mg to 300 mg/day.

How does Effexor treat PTSD?

PTSD has been reported to occur due to defects in the serotonin transport system, and lower plasma serotonin levels. When exposed to visual and aural recollections of trauma, people with PTSD exhibit noradrenergic dysregulation, with elevated heart rate and blood pressure.

Elevated urine noradrenaline levels have been repeatedly documented in PTSD patients when compared with other psychiatric disorders and control groups. It means changes in noradrenaline and serotonin may be related to the clinical signs of PTSD.

Effexor raises serotonin, norepinephrine, and dopamine levels in the brain by inhibiting transport proteins and preventing uptake at the presynaptic terminal. This activity increases the number of transmitters available at the synapse, resulting in increased activation of postsynaptic receptors (2).

What does the research suggest?

In one of the clinical trials, the researchers discovered that Effexor was effective and well-tolerated during 6-month treatment of PTSD. The study was conducted on 328 patients, men and women, with a variety of primary traumas.

Effexor had beneficial effects on PTSD and depression symptoms, quality of life, resilience and stress vulnerability, and remission rates. Changes from baseline in response to therapy were similar between the sexes, with a mean score change of -50.6 for men and -52.5 for women (3).

A 12-week, double-blind study looked at the efficacy of Effexor, sertraline, and placebo in patients (538) with PTSD. At week 12, venlafaxine had a remission score of 30.5%, whereas sertraline and placebo had 24.3% and 19.6% respectively.

Also, the Davidson Trauma Scale total and cluster ratings were substantially higher in the Effexor group than in the placebo group. Venlafaxine had a better score in terms of symptomatic treatment of reexperiencing, hyperarousal, and numbing (4).

What are the alternative therapies for PTSD?

PTSD therapies can assist the patient in gaining control of their lives. The primary treatment is psychotherapy, however, medicines may also be used.


Several methods of psychotherapy, often known as talk therapy, can be used to treat PTSD in children and adults. The different psychotherapies include:

  • Cognitive therapy: this sort of talk therapy assists the patient in identifying the ways of positive thinking. It reduces negative thought processing like negative ideas and fear of danger.
  • Exposure therapy: this behavioural therapy assists the patient in safely confronting terrifying situations and memories so that they can cope with their thoughts more effectively. 
  • Eye movement desensitization and reprocessing (EMSR): EMDR combines exposure therapy with a series of guided eye movements to assist the patient in processing painful memories and changing the reaction towards them.


Medicines are often prescribed to treat PTSD, including:

  • SSRIs like paroxetine and sertraline have been approved by the FDA for the treatment of PTSD.
  • Topiramate: it is an anti-epileptic drug that modulates glutamate neurotransmission (5). 
  • Prazosin: this drug has been reported to reduce the occurrence of nightmares during PTSD. 

Are there any side effects of Effexor during PTSD treatment?

The most common side effects of Effexor during PTSD treatment involve:

  • nausea,
  • insomnia,
  • dry mouth,
  • night sweats,
  • headache, and
  • sexual dysfunction.

Effexor; off-label treatment of PTSD

Effexor has an off-label use in the treatment of Effexor. In my opinion, taking Effexor for PTSD can be beneficial for patients who also suffer from a major depressive disorder. You should always consult your doctor if you experience side effects with Effexor. 

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Davidson J, Baldwin D, Stein DJ, Kuper E, Benattia I, Ahmed S, Pedersen R, Musgnung J. Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Archives of general psychiatry. 2006 Oct 1;63(10):1158-65.


Pae CU, Lim HK, Ajwani N, Lee C, Patkar AA. Extended-release formulation of venlafaxine in the treatment of post-traumatic stress disorder. Expert Review of Neurotherapeutics. 2007 Jun 1;7(6):603-15.


Davidson J, Baldwin D, Stein DJ, Kuper E, Benattia I, Ahmed S, Pedersen R, Musgnung J. Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Archives of general psychiatry. 2006 Oct 1;63(10):1158-65.


Davidson J, Rothbaum BO, Tucker P, Asnis G, Benattia I, Musgnung JJ. Venlafaxine extended release in posttraumatic stress disorder: a sertraline-and placebo-controlled study. Journal of clinical psychopharmacology. 2006 Jun 1;26(3):259-67.


Berlant JL. Topiramate in posttraumatic stress disorder: preliminary clinical observations. Journal of Clinical Psychiatry. 2001 Jan 1;62:60-3.

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