Can you prescribe medication if needed?

Unfortunately, in my role and the role of a counselor in general, we are not able to prescribe medications. You would need to visit with a psychiatrist who is a medical doctor with specific knowledge of mental health and appropriate medications for mental health. A counselor is a mental health professional that may be familiar with medications and their effects and side effects, but that knowledge is not to the depth of a psychiatrist's knowledge. I do know that if the medication that you are on currently is not giving you the results that you need or expect, it is definitely important to check with a medical health professional about addressing that issue and finding something that will work for you. It is possible that after 30 years of use, your body has built a tolerance to that particular medication so that its effects are not noticeable any longer. If that is the case, there may be options for a different medication or a different dosage of the same medication that will yield the results that you are looking for. You can also try counseling, if you have not already done so, to try to learn resources and skills to manage challenges with or without medication. For example, I find that engaging in habitual acts of self care can help immensely with any of the issues for which Effexor XR may be prescribed. Self care involves engaging in things that help you move towards increased health in any or all of the five areas of health. Those five areas are mental, emotional, physical, relational, and spiritual (which is of course left up to your understanding of spirituality and a higher power for yourself). These things may include physical exercise, eating right, improving sleep patterns, meditation/mindfulness, yoga, reading, writing, journaling, music, art, podcasts, dates with a partner, friend dates, and much more. It is important to find activities along these lines that fulfill you personally. No one else's regimen will necessarily be right for you. Also, taking small, measurable steps towards these activities that can be built into a habit before the next small step is the best way to make and maintain progress in these areas. I hope that these tips and information were helpful for you. Please let me know if there is anything further that I can do for you.