What are SSRIs and SNRIs?
These are two categories of antidepressants. Each category has many different medications. Selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) are the two overarching categories of antidepressants. Each category has many different medications. For example, Zoloft (sertraline) and Prozac (fluoxetine) are SSRI medications, and Effexor (venlafaxine) and Cymbalta (duloxetine) are SNRI medications.
Both SSRI and SNRI medications target serotonin to treat a range of mental health conditions, such as depression, anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
What is serotonin, and why does it matter so much?
Serotonin is a neurotransmitter known as “the feel-good chemical,” responsible for a sense of happiness. Serotonin also helps with other functions in your brain and body, not just your mood: it regulates sleep, memory, digestion, sexual desire, breathing, and body temperature. When you aren’t getting enough serotonin in your brain, all these functions start to suffer. This is why people with anxiety might have stomach issues and why sleep can be impacted when managing depression. Decreased serotonin is linked to many mental health conditions, including depression, anxiety, OCD, and PTSD.
Usually, an SSRI is the first class of antidepressant a psychiatric clinician will use due to its effectiveness and safety profile.
How about norepinephrine? What is that, and why does it also matter?
Norepinephrine is a neurotransmitter that is involved in the fight-or-flight response. It’s part of your body’s sympathetic nervous system, your emergency response system. If you’re too low on norepinephrine, both your physical and mental health could suffer. Low levels have been linked to depression, anxiety, and physical conditions like low blood pressure and sleeping problems.
Think of norepinephrine as the safety officer of your brain, ready to pull the emergency alarm system when something isn’t right. And serotonin is the relaxed coworker who organizes happy hour, but still somehow keeps everything running smoothly in the background. If either of them takes an extended vacation, the factory that is your brain is going to have a hard time running.
When an SSRI or SNRI is helpful
What can you do when you’re suffering from low serotonin and norepinephrine levels? That’s where SSRIs and SNRIs come in. They are specific classes of medications designed to target serotonin and norepinephrine. These medications don’t increase serotonin and norepinephrine levels in your brain; they work by keeping them in your brain longer. This way, they reach more nerve cells, allowing your brain to get the most out of your essential neurotransmitters. These medications are called reuptake inhibitors because they prevent the reuptake of serotonin and norepinephrine too fast for your brain to benefit.
What risks are associated with taking SSRIs and SNRIs?
Taking SSRIs can lead to side effects such as nausea, diarrhea, and sexual dysfunction. SNRIs, while sharing these common side effects, have additional risks, including a higher likelihood of withdrawal symptoms if a dose is missed and an increased risk of high blood pressure at higher doses.
Moderate, occasional alcohol consumption may be safe for people taking SSRIs or SNRIs, but heavy drinking can cause significant risks. Combining these medications with substantial alcohol intake can lead to dangerous interactions, increasing the risk of liver damage over time. Excessive alcohol use can reduce the effectiveness of the medications and worsen symptoms of depression or anxiety.
Careful monitoring can help lessen these risks and ensure the medication’s effectiveness in managing symptoms. Both types of medications are generally well-tolerated when taken as prescribed. Patients are advised to consult their health care professionals regularly to manage any adverse effects.
Are SSRIs or SNRIs safe to take while pregnant or breastfeeding?
Generally, SSRIs are safer to use while pregnant or breastfeeding compared to SNRIs, which have more side effects and a higher likelihood of withdrawal symptoms if a dose is missed. One of the most common SSRIs prescribed during pregnancy is Zoloft (sertraline).
When to talk to your psychiatric clinician about SSRI versus SNRI medications
This may seem like a lot of information, but entering a psychiatry appointment with a basic understanding of SSRIs and SNRIs can be empowering. Psychiatric clinicians often prescribe these medications to treat depression, anxiety, OCD, and PTSD, based on a thorough evaluation and diagnosis. A good clinician will welcome your questions and value your perspective on whether you feel ready to try an SSRI or SNRI.
