I have to say, I stepped up from 37.5mg to 75mg of Effexor XR after a week and was on the higher dose for almost a year and had amazing results. I have always suffered from depression and after losing a pregnancy in the second trimester my doctor put me on effexor xr immediately. It was like seeing above the clouds for the first time. I felt like myself only clear, focused and able. I had no side effects and after about a year felt it was time to start getting off as I kept missing does and not noticing any difference when I was off. I cut out cold turky without stepping down and I have to say I THANK GOD there is this drug that works for me out there. If I ever went way down again or anything ever happened, I know that I have a safety net. I know that some people have severe reactions to this drug and others, but not all do. Some people get real help from Effexor XR. Just wanted to pass my experience along.