Objective. To find factors influencing the efficacy of venlafaxine in moderate and severe depressions. Material and methods. An observational study was carried out in real clinical practice. We examined 62 patients with depression, 21 men and 41 women, aged from 19 to 61 years, treated with venlafaxine. The duration of treatment was 84 days (first at the hospital and then at home). The initial dose was 75 mg daily, mean therapeutic dose 225 mg daily. Patient’s status was assessed using clinical/psychological methods and psychometric scales (MADRS, Beck scale, CGI, UKU). Results and conclusion. The high efficacy of the drug in the treatment of severe and moderate depressions was demonstrated. Venlafaxine was mostly effective in the treatment of anxious depression and less effective for hypochondriac depression. The rapid increase in dose of venlafaxine makes it possible to reach treatment effect in shorter time without worsening drug tolerability.