Key Points:
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a class of medications (ie. venlafaxine and duloxetine) that are effective in treating depression.
- SNRI drugs also treat anxiety disorders and long-term (chronic) pain, especially nerve pain.
- SNRI medication works to increase serotonin and norepinephrine signaling in the brain, by blocking the reuptake of or transport of serotonin and norepinephrine out of the synapse.
- Adverse side effects of SNRIs include sexual dysfunction, serotonin syndrome, and increased blood pressure.
Drug Names
Common SNRI drug names: Venlafaxine (Effexor), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq), Levomilnacipran (Fetzima), Milnacipran (Savella)
Mnemonic for SNRI Drugs: "Very Depressed Doctors Like Meds"
- V- Venlafaxine
- D- Duloxetine
- D- Desvenlafaxine
- L- Levomilnacipran
- M- Milnacipran
Side Efects
Serious Side Effects of SNRIs:
- Increased blood pressure- SNRIs can elevate blood pressure, especially at higher doses.
- Serotonin syndrome- A life-threatening condition when combined with other drugs like MAOI and TCAs.
- Sexual dysfunction- Decreased libido, delayed orgasm, or erectile dysfunction.
- Increased risk of bleeding- Especially when taken with NSAIDs, aspirin, or blood thinners.
Common Side Effects of SNRIs: Nausea Dizziness, Dry mouth, Sweating, Headache, Insomnia
Mnemonic for SNRI Side Effects: "Some Nurses Do Intensive Surgery"
- S- Serotonin syndrome
- N- Nausea
- D- Dizziness
- I- Increased blood pressure
- S- Sexual dysfunction
Indications
SNRIs are primarily used to treat depression, but they also have other clinical applications:
- Major Depressive Disorder (MDD)- First-line treatment for moderate to severe depression.
- Generalized Anxiety Disorder (GAD)- Often prescribed when SSRIs are ineffective.
- Panic Disorder- Helps reduce panic attacks and associated anxiety.
- Neuropathic Pain- Especially in conditions like diabetic neuropathy.
- Fibromyalgia- Milnacipran is FDA-approved for this condition.
- Chronic Musculoskeletal Pain- Duloxetine is used for osteoarthritis and lower back pain.
Mnemonic for SNRI Indications "Depressed Anxious People Need Comfort"
- D- Depression
- A- Anxiety disorders
- P- Panic disorder
- N- Neuropathic pain
- C- Chronic pain (fibromyalgia, musculoskeletal pain)
Check out our other articles for more mnemonics on SSRI Drugs and TCA drug mnemonics.
