I would recommend skipping an extra dose of concerta. However, you should take Effexor XR to prevent withdrawal symptoms.

Do not take extra. Simply take your usual dose tomorrow.

You definitely should take the Effexor-venlafaxine. A little late will not hurt at all. A lot late and you could have some withdrawal. You know best about the Concerta - how long does it last for you? You can probably take one now and be able to sleep fine. But if you CAN skip a day, do that. Most people stay pretty well organized during a day off. Only take if you really need it to read or study something. Robert E Most, MD