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Hi Chris, You can read about Effexor here. It is possible that the Effexor is affecting your ability to sleep. Sleeplessness was listed as a side effect of the Effexor. There is also a passage regarding interactions with medications commonly prescribed for the migraines.   "This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs such as "triptans" used to treat migraine headaches (e.g., sumatriptan, eletriptan), certain antidepressants including SSRIs (e.g., citalopram, paroxetine) and other SNRIs (e.g., duloxetine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine). See also Drug Interactions section. Before taking this drug, tell your doctor if you take any of these medications. Serotonin syndrome may be more likely when you start or increase the dose of any of these medications."   Online sources like Health Central are great when you are looking for information to help you ask the important questions of your doctor. They should not take the place of your doctor's care and advice.   Take care and stay in touch. Let us know how you are doing!Vicki M