I've had an niche event ticketing Elixir/Phoenix app in production for 4 years and have had next to zero problems. It gets very bursty traffic (100s of simultaneous users when an event opens for ticket purchases with load quickly tapering off in a negative exponential distribution) and the load average barely changes with insanely fast responses on a $10 VM.
I think the only downside for me is having to squint sideways to figure out how to convert a complex SQL query into Ecto. I've been writing SQL for almost 30 years and I find myself dropping into using Ecto's `fragment` too often. I've been meaning to pickup "Programming Ecto" to educate myself more (https://pragprog.com/titles/wmecto/programming-ecto/).
I've done my share of RoR apps too and the nice thing about Elixir is there is very little magic and what magic there is (mostly via macros and code auto added via a `use` statement) can be seen and changed directly in your code instead of being hidden in some gem somewhere.