SNRI: uses and side effects of these drugs

In the treatment of depression, one of the most frequent mental disorders, a great number of number of methods and therapeutic alternatives created in order to reduce and eliminate the symptomatology.

From pharmacology, attempts have been made to synthesize different types of substances for this purpose. And among the most innovative and promising we can find a group that specifically affects different neurotransmitters that are linked to the typical processes of subjects with depression. We are talking about Specific Serotonin and Norepinephrine Reuptake Inhibitors, or SNRIs.

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SNRIs: type of substance and mechanism of action

Specific serotonin and norepinephrine reuptake inhibitors or SNRIs are a type of antidepressants that are characterized by, as their name indicates, inhibit or block the reuptake of neurotransmitters serotonin and norepinephrine in the brain

This implies that presynaptic neurons will not reabsorb the excess of these neurotransmitters not used by the neuron. postsynaptic, so they will stay in the synaptic gap and be available for postsynaptic neurons to follow acting. In other words,

make there more norepinephrine and serotonin in the brain.

We are dealing with a relatively recent group of drugs, which generally cause few secondary symptoms and together with the SSRIs They are among the most effective and safe that currently exist. Keep in mind, however, that as with all antidepressants, there is a time lag several weeks in which there is no noticeable effect, given that the brain must and will be making changes in regards to the brain receptors of these hormones.

Its advantages over other antidepressants are that it two of the main monoamines associated with depressive symptoms work, as well as the anxious.

These neurotransmitters are linked to mood, motivation (especially norepinephrine), the capacity for concentration and attention, with which aspects such as anhedonia, apathy, negative mood and different cognitive and emotional aspects. In addition, they do not usually generate histaminergic or cholinergic effects, and side effects associated with these hormones are not frequent.

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Top IRSN Examples

SNRIs are a group of drugs that share a similar mechanism of action, having different substances with different chemical compositions, properties that, although they are not the same, generate similar changes at the brain level. Some of the main exponents of this group are the following.

1. Venlafaxine

One of the best known IRSNs, venlafaxine is known for its use as a treatment for depression, being one of the most prescribed drugs of this type and the oldest of them.

It has also been used in cases of social phobia and other anxiety disorders, and has been used in post-traumatic stress disorder. In addition to serotonin and norepinephrine, it also may have some effect on dopamine in high doses.

Despite being SNRI, its effect is much greater on serotonin (it is estimated that up to five times more), and even at low doses it can only have an effect on this neurotransmitter.

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2. Duloxetine

Another of the most famous and widely used specific serotonin and norepinephrine reuptake inhibitors, duloxetine is a relatively recent ISRN. used for the treatment of major depression (being a highly effective drug in the treatment of this type of symptoms) and other mental and medical. Also its role in the treatment of urinary incontinence is known.

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3. Milnacipran

Antidepressant drug known for its role in the treatment of depressive disorders. It is also prescribed to combat the pain of fibromyalgia and other pain disorders.

4. Levomilnacipran

A psychoactive drug approved in 2013, levomilnacipran is an SNRI that has the particularity that its action on the norepinephrine practically doubles that of serotonin, this being the most noradrenergic ISRN that exists in the present. Very useful in order to alleviate motivational symptoms and improve aspects such as concentration and activity.

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5. desvenlafaxine

Derived from venlafaxine, desvenlafaxine is currently a relevant antidepressant not only because of its role in the treatment of depression but also for serving as a treatment for menopause and pain neuropathic. However its only fully approved clinical indication is for depression.

Uses and applications

Although all SNRIs are used as antidepressants for the treatment of depression, this is not the only use they can have. Many of them are used in the treatment of different anxiety disorders.d, sometimes even with greater preference than substances classified as anxiolytics, as occurs in generalized anxiety disorder or phobias (such as social anxiety).

Most of these drugs are also used to treat pain-related conditions, such as fibromyalgia, chronic fatigue syndrome and neuropathies.

Risks and side effects

Specific serotonin and norepinephrine reuptake inhibitors they are powerful psychiatric drugs very useful both in the treatment of depression and other disorders and diseases. However, this does not mean that they cannot generate unpleasant and even dangerous side effects.

As a general rule, this type of drug tends to generate sedation, gastrointestinal disturbances, nausea and vomiting, dry mouth, headache and dizziness, hyperhidrosis, urination or excretion disturbances, sleep problems such as insomnia, sexual disorders such as loss of appetite, erectile dysfunction, ejaculatory problems and to reach the orgasm.

Likewise, in some more serious cases, arrhythmias and alterations in blood pressure can occur. It must also be taken into account that they can generate or facilitate the suicidal ideation, especially at the beginning of consumption, and in some cases seizures.

As main contraindications, although they depend on the specific drug, there are usually pregnant and lactating women, people with heart, liver or kidney problems. In the case of people with diabetes, they should be especially careful and consult their doctor due to the risk of hyperglycemia. They should also not be used in conjunction with MAOS due to the risk of serotonin syndrome, and its use with alcohol or other substances and drugs is contraindicated.

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