SNRI’s: Serotonin Norepinephrine Reuptake Inhibitors

When used as anti-depressants, Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) have very similar results as Selective Serotonin Reuptake Inhibitors (SSRIs), but their mechanism of action is different.  SNRIs work by preventing the body from “cleaning up” excess serotonin and norepinephrine.  Some common examples of SNRIs are venlafaxine HCL (Effexor) and duloxetine HCL (Cymbalta).

Overall, SNRIs are very similar to SSRIs, and have relatively few side effects.  Each SNRI is a little bit different, but don’t stress about memorizing the minor differences.  In fact, if you just re-read the SSRI article, then you’ll be in pretty good shape with your knowledge of SNRIs, too!  The only detail I would add is that some clients might need to have their blood pressure monitored when beginning an SNRI, as it can sometimes cause high blood pressure.

I would also like to mention one other Atypical (Novel) Antidepressants in this conversation, though.  Atypical Antidepressants are a broader category of anti-depressants that includes SNRIs and other medications.  One commonly tested Atypical Antidepressant  is buproprion (Wellbutrin/Zyban).

Even though it is the same generic drug, the manufacturer uses a different brand name depending on what it is prescribed for.  If it’s prescribed for depression, then it’s usually called Wellbutrin.  If it’s prescribed to help a client stop smoking, it’s called Zyban.

This is important to recognize because on an exam you might be presented with a scenario where a patient who is already on Wellbutrin wants to stop smoking and requests Zyban.  Alternatively, they might comment on how they’ve recently started Wellbutrin and have found that their nicotine cravings have decreased!

In either scenario, you should choose an appropriate response that educates the patient that Zyban and Wellbutrin are actually the same medication, and therefore they shouldn’t receive two different prescriptions.  And you can also educate that it’s an expected side effect to have reduced nicotine cravings!

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