SNRIs: uses and side effects of these drugs

Specific Serotonin and Noradrenaline Reuptake Inhibitors are potent drugs.

In the treatment of depression, one of the most frequent mental disorders, a large number of methods and therapeutic alternatives have been created with the aim of reducing and eliminating the symptomatology.

Pharmacology has tried to synthesize different types of substances for this purpose. And among the most novel and promising ones we can find a group that specifically affects different neurotransmitters that are linked to the typical processes of subjects with depression. We are talking about Specific Serotonin and Noradrenaline Reuptake Inhibitors, or SNRIs..

SNRIs: type of substance and mechanism of action

Specific serotonin and norepinephrine reuptake inhibitors, or SNRIs, are a type of antidepressant. a class of antidepressants characterized by, as their name suggests, inhibiting or blocking the reuptake of the neurotransmitters serotonin and norepinephrine in the brain.

This implies that the presynaptic neurons will not reabsorb the excess of these neurotransmitters not used by the postsynaptic neuron, so that they will remain in the synaptic space and will be available for the postsynaptic neurons to continue acting. In other words, they make more noradrenaline and serotonin available in the brain..

This is a relatively recent group of drugs, which generally cause few side symptoms and, together with SSRIs, are among the most effective and safest currently available. It should be borne in mind, however, that as with all antidepressants, there is a time lag from several weeks in which they do not present a perceptible effect.The brain must and will make changes regarding the brain receptors of these hormones.

Its advantages over other antidepressants are found in that they they work two of the main monoamines associated to the depressive symptomatology, as well as to the anxious one.as well as anxious symptoms.

These neurotransmitters are linked to mood, motivation (especially norepinephrine) and (especially noradrenaline), the ability to concentrate and attention, thus treating aspects such as anhedonia, apathy, negative mood and different cognitive and emotional aspects. In addition, they do not usually generate histaminergic or cholinergic effects, and side effects associated with these hormones are not frequent.

Main examples of SNRIs

SNRIs are a group of drugs that share a similar mechanism of action, with different substances with different chemical compositions having properties that, although they are not the same, generate similar changes in the brain. Some of the main exponents of this group are the following.

Venlafaxine

One of the best known SNRIsVenlafaxine is known for its use as a treatment for depression, being one of the most prescribed drugs of this type and the oldest of them.

It has also been used in cases of social phobia and other anxiety disorders, and has been used in post-traumatic stress disorder. In addition to serotonin and norepinephrine, it may also have some effect on dopamine. may also have some effect on dopamine in high doses..

Despite being SNRI, its effect is much greater on serotonin (it is estimated that up to five times more), and even at low doses it can only have an effect on this neurotransmitter.

2. Duloxetine

Another of the most famous and widely used specific serotonin and noradrenaline reuptake inhibitors, duloxetine is a relatively recent NRRI used for the treatment of major depression (being a highly effective drug in the treatment of this type of symptoms) and other psychological and medical conditions. Also is also known to play a role in the treatment of urinary incontinence.

3. Milnacipran

Antidepressant drug known for its role in the treatment of depressive disorders. It is also prescribed to combat the pain of fibromyalgia and other pain disorders.

4. Levomilnacipran

A psychopharmaceutical approved in 2013, levomilnacipran is an SNRI whose particularity is that its action on noradrenaline practically doubles that on serotonin, making it the most noradrenergic SNRI currently available. It is very useful for alleviating motivational symptoms and to improve aspects such as concentration and activity.

5. Desvenlafaxine

Derived from venlafaxine, desvenlafaxine is currently a relevant Antidepressant not only for its role in the treatment of depression but also for serving as a treatment for menopause and neuropathic pain. However, its only fully approved clinical indication is for the treatment of menopause and neuropathic pain. its only fully approved clinical indication is for depression..

Uses and applications

While as antidepressants all SNRIs are used for the treatment of depression, this is not the only use they can have. Many of them are used in the treatment of different anxiety disorders, sometimes even more preferentially than substances classified as anxiolytics, as occurs in the treatment of depression.d, sometimes even more preferentially than substances classified as anxiolytics, as occurs in generalized anxiety disorder or phobias (such as social phobia).

Most of these drugs are also used for the treatment of pain-related ailments such as fibromyalgia, fibromyalgia syndrome, as well as for fibromyalgia, chronic fatigue syndrome and neuropathies..

Risks and side effects

Specific serotonin and norepinephrine reuptake inhibitors (SNRIs) are potent psychotropic drugs. are potent psychotropic drugs They are very useful in the treatment of depression as well as in other disorders and diseases. However, this does not mean that they cannot generate unpleasant and even dangerous side effects.

As a general rule, this type of drug tends to cause sedation, gastrointestinal tends to cause sedation, gastrointestinal disturbances, nausea and vomiting, dry mouth, headache and dizziness, hyperhidrosis, urination or excretion disturbances, sleep problemsIn general, this type of drug tends to cause sedation, gastrointestinal disturbances, nausea and vomiting, dry mouth, headache and dizziness, hyperhidrosis, alterations in urination or excretion, sleep problems such as insomnia, sexual disturbances such as lack of appetite, erectile dysfunction, ejaculatory problems and problems in reaching orgasm.

Also, in some more serious cases, arrhythmias and blood pressure alterations may occur. It should also be taken into account that they can generate or facilitate suicidal ideation, especially at the beginning of consumption, and in some cases convulsions.

The main contraindications, although they depend on the specific drug, are usually pregnant and breastfeeding women, people with heart, liver or kidney problems. In the case of people with diabetes, they should be especially cautious and consult their doctor due to the risk of hyperglycemia. They should also not be used together with MAOIs due to the risk of serotonin syndrome, and their use together with alcohol or other substances and drugs is contraindicated.