I would get jittery, restless, racing fleeting thoughts, talkative but unfocused, would sleep maybe two or three hours a night... I even had problems urinating. This was in an inpatient setting as well. I haven't heard any experiences of it combined with effexor. However "firing on all cylinders" seems a little intimidating to me, from suffering from anxiety. I week the anxiety has enough cylinders firing of already lol... But that's with chronic obsessive intrusive thoughts and paranoia