Learning library · Medication education
SNRIsDual-action antidepressants
How SNRIs act on two brain messengers, what they're used for including some pain conditions, and what to watch for as you adjust.
What SNRIs are
SNRIs, short for serotonin and norepinephrine reuptake inhibitors, are a family of antidepressants. Common ones include duloxetine, venlafaxine, and desvenlafaxine.
They're used for depression and for anxiety disorders, and duloxetine is also used for some kinds of long-lasting pain, like nerve pain from diabetes and fibromyalgia. This video is general education. Your own plan is something you and your provider decide together.
How they work
Nerve cells pass messages using chemical messengers. Like SSRIs, SNRIs slow the recycling of serotonin between nerve cells. They do the same for a second messenger, norepinephrine. That's why they're sometimes called dual-action antidepressants.
The chemistry changes within days, but the benefits on mood and anxiety build more slowly. Antidepressants usually take four to eight weeks to work, and sleep, energy, and appetite often improve before mood does.
What to expect
So the early weeks call for patience. Take it as prescribed, and keep track of how you feel. The Daily log in your portal is a good place for that.
If you've given it a fair trial and it isn't helping enough, that's useful information. Your provider may adjust the dose or suggest a different medicine.
Side effects
Common side effects include nausea, dry mouth, dizziness, sweating, constipation, changes in sleep, and sexual side effects. Many ease within the first few weeks, so mention any that bother you.
SNRIs can also raise blood pressure, so your provider may check yours during treatment, especially if you already have high blood pressure.
When to call
Like all antidepressants, SNRIs carry a warning that in children, teens, and young adults under twenty-five, they can increase suicidal thoughts or actions, especially in the first few months or after a dose change.
At any age, watch for new or worsening depression, anxiety, agitation, or thoughts of suicide, and contact your provider right away if they appear. If you're in crisis, call or text 988, any time.
Tell your provider about every medicine and supplement you take. Combining an SNRI with other medicines that raise serotonin, or with St. John's wort, can rarely cause serotonin syndrome. SNRIs can also raise the risk of bleeding with aspirin, pain relievers like ibuprofen, or blood thinners.
Stopping or changing
Don't stop an SNRI suddenly on your own. Stopping abruptly can cause discontinuation symptoms, like dizziness, nausea, headache, irritability, or brief electric-shock sensations. When it's time to stop, your provider will help you taper slowly.
Be open with your provider about alcohol. Duloxetine isn't usually a good fit for people who drink heavily or have liver disease. And if you're pregnant, planning a pregnancy, or breastfeeding, talk it through together.
Working together
SNRIs work best as part of a whole plan, often alongside therapy, sleep, movement, and support. Keep your follow-up visits, and use Messages in your portal for questions in between.
Everything here is general information, not medical advice for you. Talk with your provider before starting, stopping, or changing any medicine.
4 min · captions with the CC button · 7 chapters · animated diagrams