Taking SNRIs for Treating Panic Disorder

Often prescribed to treat mood and anxiety disorders, serotonin and norepinephrine reuptake inhibitors are one of the most commontreatment options for panic disorder.

What Are Serotonin and Norepinephrine Reuptake Inhibitors?

Serotonin and norepinephrine reuptake inhibitors(SNRIs) are one class of antidepressant medications. Some of the most common SNRIs includeEffexor(venlafaxine),Cymbalta(duloxetine), and Pristiq (desvenlafaxine). These antidepressants are frequently prescribed to treat mood disorders, such as major depressive disorder and depression inbipolar disorder.

The 5 Types of Antidepressants

How They Work in Treating Anxiety and Panic Disorders

The human brain contains hundreds of naturally occurring chemical messengers called neurotransmitters. These messengers are responsible for directing information throughout the brain. It is believed that if one or more of these neurotransmitters become unbalanced, it can contribute to a person developing a mood or anxiety disorder.

The neurotransmittersserotoninandnorepinephrineare thought to be particularly linked to the occurrence of panic disorder. Both neurotransmitters play a role in regulating certain functions and emotions that can affect the onset of this condition. Serotonin is connected to the regulation of mood and sleep. Norepinephrine is responsible for how the person reacts to stress and anxiety and is associated with thefight-or-flight response.

SNRIs are sometimes confused with selective serotonin reuptake inhibitors (SSRIs), which are similar antidepressants, but only work to affect serotonin.

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Side Effects

It is possible to experience side effects when taking SNRIs. Some of the most common side effects of SNRIs include:

These side effects should decrease over time. Consult your doctor if side effects don’t improve or worsen. It is possible to experience a serious drug allergy from SNRIs.

Contact your pharmacy or doctor immediately if you are experiencing the symptoms of allergic drug interaction, including swelling of the mouth, face, or tongue, inability to take deep breaths, choking sensations, rash, and hives.

Precautions

Black Box Warning

In 2007, the United States Food and Drug Administration (FDA) issued an advisory known as a black box warning. Through this warning, the FDA cautioned that the use of SNRIs and otherantidepressant medicationsmay lead to heightened suicidal thoughts and behaviors, particularly in young people.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Drug Interactions

Certain medications should not be taken or should be used with caution along with SNRIs. Keep your doctor up-to-date with any prescribed and over-the-counter medications you are taking.

Alcohol Consumption

Consuming alcohol can elevate the toxicity of SNRIs and can impact the effectiveness of these antidepressant medications.

Special Populations

SNRIs can be passed from mother to child during pregnancy or while nursing. If you are pregnant or nursing, discuss the potential risks of taking SNRIs with your doctor. Older adults are often more susceptible to experiencing the side effects of SNRIs. If you are an older adult taking SNRIs, talk to your doctor about potential side effects.

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother.2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Montoya A, Bruins R, Katzman MA, Blier P.The noradrenergic paradox: implications in the management of depression and anxiety.Neuropsychiatr Dis Treat.2016;12:541-557. doi:10.2147/NDT.S91311Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context.2015;4:212290. doi:10.7573/dic.212290Pompili M, Serafini G, Innamorati M, et al.Antidepressants and Suicide Risk: A Comprehensive Overview.Pharmaceuticals (Basel).2010;3(9):2861-2883. doi:10.3390/ph3092861Dubovicky M, Belovicova K, Csatlosova K, Bogi E.Risks of using SSRI / SNRI antidepressants during pregnancy and lactation.Interdiscip Toxicol. 2017;10(1):30-34. doi:10.1515/intox-2017-0004Garfield LD, Dixon D, Nowotny P, et al.Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial.Am J Geriatr Psychiatry.2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003Additional ReadingDell’osso B, Buoli M, Baldwin DS, Altamura AC.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Hum Psychopharmacol. 2010;25(1):17-29. doi:10.1002/hup.1074Gorman, J. M., & Kent, J. M. (1999). SSRIs and SNRIs: Broad Spectrum of Efficacy Beyond Major Depression.Assessing Antidepressant Efficacy: A Reexamination., Jan 1998, Phoenix, AZ, US. Physicians Postgraduate Press.Silverman, Harold M. (2010).The Pill Book.14th ed. New York, NY: Bantam Books.

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother.2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Montoya A, Bruins R, Katzman MA, Blier P.The noradrenergic paradox: implications in the management of depression and anxiety.Neuropsychiatr Dis Treat.2016;12:541-557. doi:10.2147/NDT.S91311Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context.2015;4:212290. doi:10.7573/dic.212290Pompili M, Serafini G, Innamorati M, et al.Antidepressants and Suicide Risk: A Comprehensive Overview.Pharmaceuticals (Basel).2010;3(9):2861-2883. doi:10.3390/ph3092861Dubovicky M, Belovicova K, Csatlosova K, Bogi E.Risks of using SSRI / SNRI antidepressants during pregnancy and lactation.Interdiscip Toxicol. 2017;10(1):30-34. doi:10.1515/intox-2017-0004Garfield LD, Dixon D, Nowotny P, et al.Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial.Am J Geriatr Psychiatry.2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003Additional ReadingDell’osso B, Buoli M, Baldwin DS, Altamura AC.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Hum Psychopharmacol. 2010;25(1):17-29. doi:10.1002/hup.1074Gorman, J. M., & Kent, J. M. (1999). SSRIs and SNRIs: Broad Spectrum of Efficacy Beyond Major Depression.Assessing Antidepressant Efficacy: A Reexamination., Jan 1998, Phoenix, AZ, US. Physicians Postgraduate Press.Silverman, Harold M. (2010).The Pill Book.14th ed. New York, NY: Bantam Books.

Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother.2018;19(10):1057-1070. doi:10.1080/14656566.2018.1491966Montoya A, Bruins R, Katzman MA, Blier P.The noradrenergic paradox: implications in the management of depression and anxiety.Neuropsychiatr Dis Treat.2016;12:541-557. doi:10.2147/NDT.S91311Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context.2015;4:212290. doi:10.7573/dic.212290Pompili M, Serafini G, Innamorati M, et al.Antidepressants and Suicide Risk: A Comprehensive Overview.Pharmaceuticals (Basel).2010;3(9):2861-2883. doi:10.3390/ph3092861Dubovicky M, Belovicova K, Csatlosova K, Bogi E.Risks of using SSRI / SNRI antidepressants during pregnancy and lactation.Interdiscip Toxicol. 2017;10(1):30-34. doi:10.1515/intox-2017-0004Garfield LD, Dixon D, Nowotny P, et al.Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial.Am J Geriatr Psychiatry.2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003

Montoya A, Bruins R, Katzman MA, Blier P.The noradrenergic paradox: implications in the management of depression and anxiety.Neuropsychiatr Dis Treat.2016;12:541-557. doi:10.2147/NDT.S91311

Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context.2015;4:212290. doi:10.7573/dic.212290

Pompili M, Serafini G, Innamorati M, et al.Antidepressants and Suicide Risk: A Comprehensive Overview.Pharmaceuticals (Basel).2010;3(9):2861-2883. doi:10.3390/ph3092861

Dubovicky M, Belovicova K, Csatlosova K, Bogi E.Risks of using SSRI / SNRI antidepressants during pregnancy and lactation.Interdiscip Toxicol. 2017;10(1):30-34. doi:10.1515/intox-2017-0004

Garfield LD, Dixon D, Nowotny P, et al.Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial.Am J Geriatr Psychiatry.2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003

Dell’osso B, Buoli M, Baldwin DS, Altamura AC.Serotonin norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive review of their clinical efficacy.Hum Psychopharmacol. 2010;25(1):17-29. doi:10.1002/hup.1074Gorman, J. M., & Kent, J. M. (1999). SSRIs and SNRIs: Broad Spectrum of Efficacy Beyond Major Depression.Assessing Antidepressant Efficacy: A Reexamination., Jan 1998, Phoenix, AZ, US. Physicians Postgraduate Press.Silverman, Harold M. (2010).The Pill Book.14th ed. New York, NY: Bantam Books.

Gorman, J. M., & Kent, J. M. (1999). SSRIs and SNRIs: Broad Spectrum of Efficacy Beyond Major Depression.Assessing Antidepressant Efficacy: A Reexamination., Jan 1998, Phoenix, AZ, US. Physicians Postgraduate Press.

Silverman, Harold M. (2010).The Pill Book.14th ed. New York, NY: Bantam Books.

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What Are Serotonin and Norepinephrine Reuptake Inhibitors?#

How They Work in Treating Anxiety and Panic Disorders#

Press Play for Advice On Dealing With Depression#

Side Effects#

Precautions#

Black Box Warning#

Drug Interactions#

Alcohol Consumption#

Special Populations#