I would first talk to my doctor about taking tylenol pm along with the Effexor....don't know if that might be why you are feeling this way. These types of medications work differently for everyone, for some people adjustment period takes effect right away for others it takes a good 4 to 6 weeks. I know that when I was given effexor, I felt dizzy and completed out of it. I talked to my doctor and he immediatley took me off of it, was not for me. but do not get discouraged, it might be the one for you. But it was not for me, I simply got worse. If it is really bothering you that bad, and you don't feel you should be feeling this way, do what I did, I called my doctor.
Take care and keep us posted on how you are doing.