Thanks, I am planning on calling the dr today.
Snris such as Effexor have a much greater connection with liver problems than Lexapro, as far as I'm aware. I agree, 40mg of Lexapro is high, but I haven't heard of any significant liver issues with ssris but when Cymbalta, an snri, applied to FDA for approval for pain control they discovered a lot of liver issues. You might bring this up with your doc.
Call the doctor who prescribed the meds. Explain the lack of sleep but DON'T STOP taking the Effexor until told to do so. Wait until you can talk with your doctor and express your concerns face to face or over the phone.