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Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are a type of antidepressant used to treat clinical depression. They can also be effective in treatments for diabetic neuropathy and certain anxiety disorders and social phobias.  SRIs act on specific chemicals in the brain, i.e. serotonin and norepinephrine. These medications impede the brain’s reuptake of these chemicals keeping more of the chemicals in the cells where they have a better chance of activating the receptors in nearby cells. As a result, they work to improve mood and keep these brain chemicals functioning at their optimum levels.

The most common SNRIs used to treat depression are Duloxetine (Cymbalta) and Venlafaxine (Effexor, Efexor XR).

Seritonin and norephinephrine reuptake inhibitors, as a general rule, should be taken with food to counteract the nausea that is a common side effect of the medications. It’s important to take the medications according to your doctor’s specifications and to do so at the same time of day every day. This will ensure that there is an even amount of the medication in the blood. Under no circumstances should you stop this medication without seeking the assistance of a qualified medical and/or mental health professional. If you do forget a dose on a given day, just take the prescribed amount at your next dose. Do not DOUBLE UP! An overdose of an SNRI requires immediate medical attention.

The most common side effects of SNRIs include:

  • Nausea
  • Upset stomach
  • Generalized body weakness
  • Loss of appetite
  • Vomiting
  • Dizziness
  • Sleeplessness
  • Abnormal dreams
  • Dry mouth
  • Yawning
  • Constipation
  • Sweating
  • Weight loss
  • Gas
  • Anxiety
  • Agitation
  • Blurred vision and/or double vision
  • Headache
  • Decreased sex drive
  • Difficulty with reaching orgasms
  • Inexplicable shaking, tremors

IIt’s important to tell your doctor of any other conditions you have prior to taking this medication and let him/her know all the medications, both over the counter and prescription you take. This does include herbal and dietary supplements. (For example, St. John’s Wort has been known to interact negatively with SNRIs in some cases.)

In some people, noepinephrine inhibitors can elevate blood pressure and, in some instances, blood cholesterol levels. If you already have hypertension (high blood pressure), it may be wise to consider an alternative class of medication. Either way, it’s probably a good idea to monitor your blood pressure on a regular basis once you begin treatment.

Individuals with bipolar disorder (aka manic depression), heart problems including a recent heart attack, previous suicide attempts and/or thoughts of suicide, epilepsy or seizure disorders, glaucoma, liver disease, kidney problems and certain allergies should exercise caution in taking this medication. The best thing to do is to make your doctor aware of the condition and he/she can adjust your medication accordingly.

If you plan to become or are currently pregnant, you must let your doctor know. SNRIs are currently considered a Pregnancy Category C medication by the Food & Drug Administration (FDA). Therefore, the medication has shown to affect fetuses of animals during drug testing. However, it has not been sufficiently tested on humans. There have been reports showing that fetuses exposed to the medication in the third trimester have developed certain complications that may require hospitalization after birth.

Your doctor will consider both the benefits and risks of continuing to take the medication during pregnancy before making a recommendation on your situation.