I was on and off on Zoloft for a few years but it wasn't working. My Doc gave me Effexor, I started at 75mg over 10 years ago. He also gave me Lithobid. He increased the Effexor to 150mg. I was at that dosage for years. Then I spiraled into a bad depression so he increased it to 225mg. I went back and forth depending on my depression. I've settled at 225mg. I notice immediately when I don't take the Effexor for more than one day. I get anxious, I cry at the drop of a hat, I feel stressed. When I take it again, within a half a day I'm feeling better. I also take Wellbutrin XL 300 mg. I don't notice much when I don't take it. However after a week or so I start feeling depressed, lethargic. So what I'm trying to say, if I had to give up my meds I would with the exception of Effexor. For me it's the miracle drug. I just wish it were not as expensive.