Antidepressants (SNRIs)
- Antidepressants that add NET blockade
- MDD/anxiety; some also treat pain
- duloxetine: pain + GAD
- venlafaxine: strong anxiety evidence
- BP/HR can rise, especially at higher doses
- Sexual/GI effects resemble SSRIs
- Venlafaxine: prominent withdrawal
- Never combine with an MAOI
Class at a glance
- Antidepressants that add NET blockade
Members / distinctions
- Venlafaxine: prominent withdrawal
Clinical role
- MDD/anxiety; some also treat pain
- duloxetine: pain + GAD
- venlafaxine: strong anxiety evidence
- BP/HR can rise, especially at higher doses
Safety / monitoring
- Sexual/GI effects resemble SSRIs
- Never combine with an MAOI
Pearls
- Add sweating, constipation, urinary retention beyond SSRI effects
- BP rise greatest with venlafaxine above 150 mg/day
- Duloxetine: hepatotoxicity; caution in chronic liver disease
- Venlafaxine works off-label for migraine prevention
Self-check
- Which SNRI has prominent withdrawal?
Venlafaxine. - How can SNRIs affect BP/HR, especially at higher doses?
Both can rise.
Drugs in this class (5)
Antidepressants (SNRIs) prescription history
Animated chart of estimated U.S. prescriptions per year, Antidepressants (1957–2026). SNRI highlighted from 1993.
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