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Greg, I have been on Effexor Xr now for about six months, in that time my liver alkaline phosphasates have elevated from about 150 up to 246.  I am a survivor of Hodgkins Lymphoma and my oncologist is freaking and has been doing all sorts of test that has to  do with  the liver and what causes elevation.  I have had the normal  ct scans, cancer is still in remission, also elevated liver comes from bones, so I  had a bone  nuclear med test, just showed arthritis.  This week I had a PET scan which would pick up everything else that could cause this elevation.  I  did  some research  on the net and found that 94% of effexor is abosorped in the liver and it metabolizes there causing the  elevated numbers.  My question is that if I  stay on the effexor and the numbers keep climbing, is this actually doing more damage to my liver?????  I will find out  more this week.  Good luck  with  the insurance issue, but that is what I am dealing with  and I honestly  believe that it is caused by the medication.