Updated: 6/2/2016

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

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Snapshot
  • A 69-year-old male presents to clinic for follow up of his diabetes and depression.  He states that behavioral therapy has not helped for his mood and that he would be interested in trying a medication.  In addition, he also complains of a painful, electrical/tingling sensation in his legs that he was hoping you could also treat.  He is very hesitant to take any medications and would prefer to take as few as possible.
Overview
  • Drugs
    • venlafaxine
    • duloxetine
  • Mechanism
    • inhibits 5-HT and NE reuptake
      • duloxetine has greater blockade on NE
  • Clinical use
    • depression
    • fibromyalgia
    • generalized anxiety disorder
      • venlafaxine
    • diabetic peripheral neuropathy
      • duloxetine
  • Toxicity
    • most common is ↑ BP, stimulant effects
      • due to ↑ in NE
    • sedation
    • nausea

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