Dual reuptake inhibitors/SNRI's

Question 1

Examples of SNRI’s?

Answer 1

duloxetine, venlafaxine

Question 2

Main indications for SNRI’s?

Answer 2

• Major depression
• Generalised anxiety disorder, social anxiety disorder and panic disorder.
• Duloxetine is also good for neuropathic pain and urge incontinence.

Question 3

SNRI mechanism of action?

Answer 3

• Blocks reuptake of monoamines (noradrenaline and 5-HT) into presynaptic terminals
• May be slightly more effective than SSRI’s but associated with higher rate of adverse effects

Question 4

Contraindications and cautions?

Answer 4

Contraindicated in uncontrolled hypertension

Question 5

Adverse effects of SNRI’s?

Answer 5

• Similar to SSRI’s
• Lacks major receptor blocking actions (e.g. anticholinergic) so more limited range of side effects.

Question 6

Administration of SNRI?

Answer 6

PO (orally)

Question 7

When can SNRI’s be used instead of SSRI’s?

Answer 7

SSRIs impact your levels of serotonin, SNRIs impact the levels of both serotonin and norepinephrine.

Aside from treating depression, SNRIs are sometimes used to treat other conditions, including anxiety disorders and chronic pain, especially chronic nerve pain.