Antidepressant response could be from 42 to 50% genetically determined. Venlafaxine (VEN) was the sixth most-prescribed antidepressant in the USA in 2017. Therefore, we reviewed studies which focused on the pharmacogenetics of VEN and found that there is a lack of guidelines for pharmacogenetic testing for VEN. Within investigated genetic polymorphisms, few of them can be indicated as potential predictors of VEN efficacy and tolerance. However, additional pharmacogenetic studies of VEN should be performed to reproduce already obtained results or explain contradictory ones. The individualization of pharmacotherapy is a key issue in providing patients with the highest possible quality of treatment, therefore pharmacogenetic studies should be one of the components of therapy optimization.

Pharmacovigilance is an important aspect of depression treatment, considering that 40–90% of patients experience side effects of antidepressant use. This paper discusses the issues of optimising the use of venlafaxine, including its pharmacodynamic and pharmacokinetic properties, indications, adverse effects and risk factors for their occurrence, such as co-morbidities or genetic polymorphisms and interactions with other drugs.