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Venlafaxine is an antidepressant drug that is FDA-approved to treat major depressive disorder, generalized anxiety disorder, social anxiety disorder, and panic disorder. It is also used off-label to treat a variety of other mental health conditions.

It is an oral tablet in the serotonin-norepinephrine reuptake inhibitor (SNRI) class, which blocks serotonin and norepinephrine’s reabsorption (or reuptake) back into nerve cells. Blocking their reuptake increases the levels of these neurotransmitters in the brain, which may improve focus and alertness and boost mood.

The brand name Effexor has been discontinued in the U.S., but Effexor XR (meaning extended release) is still available by prescription.

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What Effexor Is Prescribed For

Effexor is mainly used to treat anxiety and depression. The four conditions it has been FDA-approved to treat are:

Doctors also sometimes prescribe Effexor off-label to treat other conditions, including:

Off-label use is both legal and common. It simply means that a doctor is prescribing a medication to treat a condition other than what it has been officially indicated to treat. However, a 2017 study found that Effexor was one of the medications least likely to be prescribed for off-label use.

One study found that Effexor was one of the most effective antidepressants. While Effexor can be a strong antidepressant, individual effects and tolerance may vary. Working with your doctor to determine which option is right for you is crucial.

What Kind of Side Effects to Expect

• Constipation
• Diarrhea
• Drowsiness
• Feeling tired
• Headache
• Heartburn
• Loss of appetite
• Nausea
• Sexual side effects
• Vomiting

Effexor may make you drowsy when you first start taking it, but this side effect often goes away or improves after a week or two. Some people may also experience insomnia or nightmares. Over time, you may also notice improvements in mood and increased energy levels.

Things to Know Before You Start Effexor

Effexor should not be taken with or within two weeks of taking monoamine oxidase inhibitors (MAOIs). Examples of MAOIs include:

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Precautions

Make sure your doctor knows your complete medical history. Effexor should be used with caution if you have:

• Brain disease, damage, or a history of seizures: The risk of seizures may increase when taking Effexor.
• Heart disease or high or low blood pressure: Effexor may occasionally make these conditions worse.
• History of mania: The risk of developing mania may be increased while taking Effexor. This is very important for bipolar patients to watch for.
• Kidney disease or liver disease: Higher blood levels of Effexor may occur, increasing the chance of side effects. Your doctor may need to adjust your dose.

How to Take Effexor

Effexor XR is taken once each day. Typical doses range from 37.5 mg to 225 mg, with a typical target dose of 75 mg per day. Your healthcare provider will typically start at a lower amount and gradually increase the dose until they determine the right dose for you.

The medication should be taken with food at any time of day, morning or night. However, if you have trouble sleeping after taking Effexor, it may be best to take your medication in the morning.

Important Warnings and Drug Interactions

Warnings are established to both ensure the safe use and discontinuation of Effexor. Your doctor should monitor you for the following complications while you’re taking Effexor.

Serotonin Syndrome

Be careful when mixing Effexor with other medicines that also affect serotonin levels, such as other antidepressants, lithium, and St. John’s wort. Doing so can lead to an excessive serotonin buildup in the brain. This can cause a condition called serotonin syndrome.

Symptoms of serotonin syndrome include:

• Confusion
• Diarrhea
• Dilated pupils
• Fever
• Loss of muscle coordination
• Muscle stiffness
• Sudden spikes in blood pressure or heart rate
• Sweating or shivering
• Twitching muscles
• Unusual agitation or restlessness

Risk of Overdose

You should always avoid drinking or using other drugs while you’re taking Effexor. These substances may decrease the benefits of the medication, or they can result in a toxic overdose. The most common Effexor overdose effects include:

• Changes in consciousness (ranging from sleepiness to coma)
• Dilated pupils
• Fast heart rate
• Seizures
• Vomiting

To reduce your risk of overdose, your doctor will only prescribe you the lowest possible dose in the smallest quantity.

Suicidal Thoughts and Actions

Children and young people (up to age 25) may experience increased suicidal thoughts and behaviors when taking antidepressant medications. The danger is most significant in the first few months of treatment or when changing the dose.

Though this warning is true for all antidepressants, taking Effexor may increase your risk even more. A major study found that Effexor was associated with a higher risk of both completed and attempted suicide compared with other antidepressants, including Celexa (citalopram), Prozac (fluoxetine), and Prothiaden (dothiepin).

Discontinuation Syndrome

Stopping Effexor abruptly may result in one of more of the following withdrawal symptoms:

• Anxiety or worsening of depression
• Dizziness
• Gastrointestinal upset
• Headaches
• Irritability
• Nausea
• Nightmares
• Paresthesias (prickling, tingling sensation on the skin)
• Vomiting

Key Takeaways

• Effexor (venlafaxine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is used to treat depression, anxiety, ADHD, OCD, and other conditions.
• Common side effects of Effexor include constipation, diarrhea, drowsiness, headache, heartburn, nausea, and vomiting. 
• It’s important to avoid taking venlafaxine with certain medications, including MAOIs, lithium, and other medicines or supplements that affect serotonin levels. Caution should be used if you have a history of seizures, cardiovascular disease, high or low blood pressure, a history of mania, or kidney or liver disease.

The National Center for Cultural Competence (NCCC) defines cultural awareness, aka cultural sensitivity, as being cognizant, observant, and conscious of the similarities and differences among and between cultural groups.

It allows us to see and respect other perspectives and appreciate the inherent value of people who are different from us. It leads to better relationships, healthier work environments, and a more compassionate society.

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5 Reasons Why Cultural Awareness Matters

Cultural awareness involves learning about cultures that are different from your own. But it’s also about being respectful about these differences, says Natalie Page EdD, chief diversity officer at Saint Xavier University in Chicago.

“It’s about being sensitive to the similarities and differences that can exist between different cultures and using this sensitivity to effectively communicate without prejudice and racism,” she explains.

1. Greater cultural competence: When you strive to become more culturally aware, you gain knowledge and information about different cultures, which leads to greater cultural competence, says Dr. Page.
2. Increased cultural sensitivity: Engaging in cultural awareness makes you more sensitive to the differences between cultures that are different than your own, Dr. Page says; you also become less judgmental of people who are different.
3. Better workplace culture: Studies have found that greater cultural awareness in the workplace leads to an overall better workplace culture for everyone involved.
4. Better healthcare: Research has found that cultural awareness creates better outcomes for people in healthcare environments and in other environments where people receive care from others.
5. Better relationships: According to Nika White, PhD, author of “Inclusion Uncomplicated: A Transformative Guide to Simplify DEI,” cultural awareness can improve your interpersonal relationships. “Just like any other relationship, you must understand their culture to truly understand someone’s lived experiences and how they show up to the world,” Dr. White says.

How to Be More Culturally Aware

Knowing about the importance of being more culturally aware is one thing, but actually taking steps to do so is something else.

Here are a few tips for how to go about becoming more culturally aware.

Understand That It’s a Process

“Becoming culturally aware is a process that is fluid, birthed out of a desire to learn more about other cultures,” says Dr. Page.

She says it can be helpful to study the model laid out by Dr. Ibram Kendi, the author of “How To Be An Antiracist“. Dr. Kendi says that there are three paths to growing cultural awareness:

• The fear zone: “The first is moving from the fear zone, where you are afraid and would rather stay in your own culture comfort zone,” Dr. Page describes.
• The learning zone: Next is moving into the learning zone, where you strive to learn about different cultures, how people acquire their cultures, and culture’s important role in personal identities, practices, and mental and physical health of individuals and communities. The learning zone can also include becoming more aware of your own culturally shaped values, beliefs, and biases, and how they impact the way you see yourself and others.
• The growth zone: “The last phase is the growth zone, where you grow in racial advocacy and allyship,” says Dr. Page.

Ask Questions

Dr. White says that asking questions is a vital part of becoming more culturally aware. But it’s important to engage in conversations with others about their cultures in respectful, appropriate manners. Be mindful that they may not want to answer, and know that that’s okay, says Dr. White.

You can start by asking yourself some important questions, such as: “How is my culture affecting how I interact with and perceive others?” Dr. White suggests.

Educate Yourself and Do the Work

• Be proactive: There’s no way around it: if you want to become more culturally aware, you need to take action and educate yourself.
• Avoid assumptions: “Don’t lean on assumptions,” says Dr. White. “Actually research cultures different from yours.” This can help you become more aware of how culture affects every aspect of your life and the lives of others.
• Have conversations: In addition to research, educating yourself often involves seeking and participating in meaningful interactions with people of differing cultural backgrounds. “Expand your network to include people from different cultures into your circle,” Dr. White recommends.

Study the Cultural Competence Continuum Model

The Cultural Competence Continuum Model is an assessment tool that helps us understand where people are on their journey to becoming more culturally competent.

Different people fall into various categories along the continuum. Categories include:

• Cultural destructiveness
• Cultural incapacity
• Cultural blindness
• Cultural pre-competence
• Cultural competence
• Cultural proficiency

Studying this model can help us become more aware of moving toward more cultural sensitivity and more patient with ourselves and others as we do so.

Acknowledge Your Own Bias

We all have our own biases when it comes to cultural awareness, because we all begin by looking at the world and at others through our own cultural lens.

Acknowledging this is important as it can help us see how our cultural biases may prevent us from being as culturally sensitive as we wish to be.

What If I Say the Wrong Thing?

• Don’t avoid cultural conversations: Often, people don’t want to address topics related to culture or race because they are afraid they will say the wrong thing or make a mistake while talking to someone.
• Apologize: “If you make a mistake, simply apologize and let the person that you may have offended know that you are learning and be open to any suggestions they may have,” she recommends.
• Acknowledge it beforehand: Sometimes it even makes sense to apologize in advance, if you are saying something you are unsure of. You can say, “I may have this wrong, so I apologize beforehand, but…” Dr. Page suggests.
• Be sincere: “The key is to be sincere in your conversations and always open to learning from others,” she says.
• Remember mistakes happen: The truth is, most people make mistakes on their journey toward cultural awareness, and that’s understandable, says Dr. Page. Making mistakes is a necessary part of the learning process, and it is important to approach these topics and conversations with shared respect, compassion, and grace.

Showing Respect in Intercultural/Interracial Relationships

If you are in a relationship with someone who is of a different race or culture from you, it’s important to have open, honest discussions about this. “If a person is going to grow in interracial and intercultural relationships, you have to step out of your cultural comfort zone and seek an understanding about other cultures,” says Dr. Page.

Questions to Ask Your Partner

Having a genuine discussion with someone about your differences can feel awkward, and it can be helpful to kick-start the conversation with a few open-ended questions. Dr. White shared some helpful questions:

• Can you tell me about your culture?
• Tell me a little something about how you were raised?
• What role does religion play in your life?

Here are some additional questions that could be asked with respect and consent, to another (and also to yourself!):

• What holidays and celebrations are important in your culture?
• What customs and etiquette are important in your culture?
• What is your favorite food in your culture?
• Is religion an important part of life in your culture? If so, what religion do people practice most often and why do you think that is?
• How do you express your cultural identity?
• What stereotypes or misconceptions do people from your culture often face and what do you wish more people knew?
• Is there anything about your culture that you find challenging?
• How has your culture changed over time?
• How do you think your culture has influenced your personal values and beliefs?
• What is the importance of family in your culture?

The Risks of Ignoring Cultural Awareness

The main pitfalls of not developing cultural awareness is that we don’t expand our understanding of other cultures, we don’t deepen our relationship with people who are different than we are, and that we risk continuing to have a narrow view of the world around us. 

Key Takeaways

• Cultural awareness allows us to understand and value people who differ from us. It not only allows us to become more culturally competent and sensitive, but it also creates a more supportive society that fosters better relationships, stronger workplaces, and better care for all people.
• Becoming more culturally aware is a continual process, and it can help to be curious, open-minded, willing to ask questions, desire to learn about the differences between cultures, and open to becoming conscious of one’s own culturally shaped values, beliefs, perceptions, and biases.
• You can show respect for others by taking an interest in learning more and being mindful in cultural conversations. Understand the risks of not cultivating cultural awareness, then take steps to become more informed.

“You have cancer.” Three dreaded words you hope you’ll never have to hear in your lifetime, for yourself or for someone you love. The unspoken volume of the phrase ironically deafening to hear. So much so that whatever language follows it up temporarily causes people to disassociate and spiral down a rabbit hole of fear, confusion, questions, numbness, or a combination of all of the above.

There is no easy way to face a cancer diagnosis and the prospect of lengthy, demanding, and often exhausting treatment. It requires a strength you may not even know you possess, and takes a toll on your mental health as much as your physical health.

Whether you’re fresh off an initial diagnosis, in the thick of treatment, or managing survivorship, each stage of this disease comes with its own challenges—all of which are evident in this collection of stories. Luckily, there are tools and professionals that can support you on your cancer journey and help you regain a sense of control in your body and life.

Seeking professional support can guide you through the inherent emotional ups and downs, help you problem solve in the face of difficult choices, and let you tap into the inner strength that you’ll need to face treatment, side effects, and any surprises that might accompany your illness.

If you or a loved one is going through cancer treatment, Verywell Mind is here with expert guidance, inspiring firsthand accounts, and self-care strategies tailored to help you deal with the stress, fear, and everything else that come with a cancer diagnosis. Reminder: your feelings are all valid, and you don’t have to go through this period alone.