Depression is a common mental health condition affecting millions of people worldwide. It can impact a person's daily life and relationships, making it crucial to seek treatment. Two of the most commonly prescribed medications for depression are Effexor and Prozac. Both are classified as antidepressants and work by altering the levels of neurotransmitters in the brain.

Despite their similarities, Effexor and Prozac have distinct differences in their benefits, dosage, and potential side effects. This article aims to explore the similarities and differences between Effexor and Prozac, helping individuals make an informed decision about their depression treatment options.

Conditions Treated by Effexor and Prozac

  • Effexor treats:
  • In adults Effexor is approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Although not FDA approved, Effexor is also used off label for migraine prophylaxis, post-traumatic stress disorder (PTSD), neuropathic pain (nerve pain), and cataplexy.
  • Effexor is not FDA approved for use in pediatrics, although it is still used off label for MDD, GAD, attention deficit hyperactivity disorder (ADHD), and cataplexy.
  • Prozac treats:
  • Prozac is FDA approved for adults in the treatment of MDD, treatment resistant MDD, obsessive compulsive disorder (OCD), bulimia nervosa, panic disorder, premenstrual dysphoric disorder (PDD), and bipolar 1 disorder. While not technically approved for it, Prozac is also used off label for cataplexy.
  • Prozac use is approved in pediatric patients for MDD, OCD, and bipolar 1 disorder. Off label it is also used in pediatrics for the treatment of bulimia nervosa, insomnia, PTSD, social anxiety disorder, and cataplexy.

Is Effexor or Prozac more Effective?

Prozac has a higher rating than Effexor according to reviewers. 65% of reviewers report a positive impact while using Prozac, while reviewers only gave Effexor a positive impact 60% of the time. Only 19% of Prozac reviewers stated a negative effect compared with 25 % of Effexor reviewers.

In a meta-analysis, Effexor was shown to be more effective but also had more dropouts than fluoxetine. So, while Effexor may work better, Prozac is more tolerable.

Making Antidepressants Work for You

Depression often requires trying multiple different medications. However, patients are generally able to find a medication that works for them if they are patient Being patient while you are suffering from depression is a lot to ask.  If you could know ahead of time which medicines would most likely benefit you with the least side effects, then you could potentially start with the right medication the first time. Pharmacogenomic testing provides this opportunity. Knowing ahead of time could save you money, heart ache, and time.

It is important to take a medication exactly as prescribed, especially psychoactive medicines like antidepressants. Learn which over the counter medications you should avoid, and ask your pharmacist how your current medications might affect your new antidepressant. Avoid alcohol and other psychoactive substances. Remember to stay in conversation with your prescriber and let them know right away if you have any issues while starting the medication. Most of the time it takes 4 – 6 weeks before you know if this one is the best one for your depression.

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What is the Most Important Information I Should Know about Prozac?

Fluoxetine is the generic name for Prozac. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that helps keep serotonin available for use in your body. Serotonin is a neurotransmitter that helps regulate many bodily functions including mood, appetite, and sleep. Increasing serotonin levels has been shown to improve mood. However, serotonin toxicity can occur if levels become too high. Serotonin syndrome, or excess levels of serotonin, can be a life threatening issue. Knowing which medications or over the counter medicines to avoid while taking Prozac can reduce the risk of serotonin syndrome.

What should you tell your healthcare provider before taking Prozac?

Prior to beginning treatment with Prozac, you should let your prescriber know of any of the following:

  • Recent MAO inhibitor use, or the need to begin one
  • Other antidepressants
  • If you’ve ever had cirrhosis of the liver, problems urinating, diabetes, glaucoma, seizures/epilepsy, manic depression, drug abuse, suicidal thoughts, electroconvulsive therapy (ECT)
  • Whether you may be pregnant or are nursing.

What are the Side Effects of Prozac?

  • Common side effects: Anxiety, constipation, diarrhea, dizziness, dry mouth, dyspepsia, flu syndrome, headache, insomnia, loss of appetite, nausea, pharyngitis, rash, sleepiness, sweating, tremor, weakness, weight loss, yawning
  • Serious side effects: Suicidal thoughts, increased depression, mania, serotonin syndrome, bleeding, major rash, glaucoma, seizures, low sodium, extrapyramidal symptoms

What are the Advantages of Taking Prozac over Effexor?

  • Prozac is available as capsules, tablets, and a solution for those who cannot swallow pills. Effexor is only available as capsules or tablets.
  • Prozac is an older medication available for a very affordable price. It has been used with success with multiple mental health disorders. Prozac is less likely to cause daytime drowsiness than Effexor. Prozac also may treat eating disorders with success.
  • Prozac only affects serotonin levels in the body which may make it easier to tolerate.
  • Prozac stays in the body longer than Effexor. With this reduced excretion, Prozac is easier on the patient with less consequences for missing a single dose and an easier time stopping the medication if desired. Effexor, on the other hand, can lead to withdrawal symptoms after just a few missed doses and needs instead to be withdrawn from slowly.
  • Dose reductions are not required automatically for renally impaired patients. Effexor, instead, may require dosage adjustments depending on kidney function.

What is the Most Important Information I Should Know about Effexor?

Effexor, also known as venlafaxine, is a selective serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs increase the availability of the neurotransmitters norepinephrine, serotonin, and dopamine. Norepinephrine helps your body with it’s fight or flight response to stress by increasing heart rate and blood pressure. Norepinephrine also helps with regulating mood and attention. Serotonin helps regulate mood, appetite, and sleep. Dopamine helps regulate movement, motivation, reward, and mood. Effexor, therefore, can impact all of these bodily functions.

What should you tell your healthcare provider before taking Effexor?

  • Take any of the following:
  • Recent use of MAO inhibitor
  • use of stimulant medicine
  • opioid medicine
  • herbal products
  • other medications for depression
  • nausea/vomiting medications
  • Have a history of:
  • mental illness,
  • Parkinson’s disease,
  • migraines,
  • serious infections
  • Whether you’ve had
  • manic depression
  • liver disease
  • kidney disease
  • heart disease
  • diabetes
  • glaucoma
  • thyroid issues
  • seizure
  • sexual problems
  • bleeding problems
  • low levels of sodium
  • Whether you could be pregnant or breastfeed
  • Effexor may not be safe to use during pregnancy, especially the third trimester.

What are the Side Effects of Effexor?

  • Common side effects: Anxiety, constipation/diarrhea, dizziness, dry mouth, headache, high blood pressure, insomnia, loss of appetite, nausea, sleepiness, tremor, weight loss
  • Serious side effects: suicidal thoughts, increased depression, mania, bleeding, seizures, low sodium pancreatitis, extrapyramidal symptoms, major rash, cardiomyopathy, pneumonia
  • Discontinuation syndrome can occur if dosages are skipped or if medication is stopped suddenly. Effexor withdrawal symptoms can occur if multiple doses are skipped or if Effexor is abruptly stopped. These symptoms may include dizziness, headaches, nausea, diarrhea, vivid dreams, anxiety, electric shock sensations, sweating or hot flashes, mood swings, and fatigue. Tapering off medication is recommended.

What are the Advantages of Taking Effexor over Prozac?

  • Effexor is a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs inhibit the reuptake of norepinephrine, serotonin, and dopamine allowing these important neurotransmitters to be available longer.
  • Effexor may be able to treat your depression even if Prozac was ineffective. Prozac only inhibits the reuptake of serotonin. You may find that increased levels of serotonin alone are not enough to improve your condition.
  • Effexor may be able to reduce nerve pain for patients who have diabetic neuropathy.


Effexor and Prozac are common antidepressant medications. They both have a generally good track record and can be tolerated well depending on the person. Those patients who do not tolerate them well, or have little success treating their depression, may be genetically distinct from those who have fewer issues. Your pharmacogenomics can determine which medicines may work best and which ones may best be avoided. ClarityX offers the Mindwell test to help you and your prescriber treat your depression or other mental illness better with fewer trial-and-error attempts.

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