"i have suffered from severe anxiety and depression since 2002 when i had cancer and did chemo.  the chemotherapy i did saved my life but it messed up my hormones so much that i went into premenopause at the age of 17.  i have been on various doses of effexor xr for the last 8 years ranging from 75-300mg a day.  i needed medication to live a normal life.  in the last year or two, i had been progressively getting worse until i felt like i was spiraling out of control.  i had been working with my doctor to find a solution but nothing was working.  extra meds were not helping.
desperate, i tried niacin.  500mg a day.  flushing is worth it.  i am now off effexor, and on niacin instead and it works better with less side effects, only the flush."