You're SUPPOSED to level out -- that's how you tell it's working -- no up and down, or just plain really, really down moods, just kind of cruising along not really feeling any extreme feelings.

I've been on it for so long I have no idea when my pdoc decided to ramp it up at whatever times. Technically, for XR, the max dose is 225 mg, but most pdocs will take it to 375 mg like the regular Effexor. It doesn't seem to do any harm.

I've been on 450 mg for about a year, after 2 hospitalizations last year. I was told by two pdocs, my in-house guy (my regular pdoc doesn't do inpatient) and my regular guy, that you go over the maximum "when nothing else is working." I called my regular pdoc after the inpatient guy upped to me to 450, just to check. He said, "Oh, I'd trust him on this one -- he sees the really HARD-CORE cases in the hospital."

Yay, I'm a chronic headcase! Yay!

I take mine in the morning because, for the first 3 weeks I took it, it had me bouncing off the ceiling, almost manic. I don't know how it works for anyone else, but I get really lethargic when I'm really depressed and so they give me things that are known to "energize."

Have never had a side effect, ever. Love the stuff. Good luck.

Candy