I was talking to my therapist about mine and my mom's anxiety medicine. I'm taking Zoloft and she's taking Cymbalta. I was talking to my therapist about how my mom wants me to get out on what she's taking but my therapist was saying that it was a different class of drugs and that Cymbalta is an SNRI while Zoloft is a SSRI. She also said that there are more side effects coming off and getting out on SNRI's as opposed to SSRI's and I was just curious to know more about them.
What's the difference between SSRI's and SNRI's?
Question posted by Mmk2017 on 27 March 2014
Last updated on 4 January 2017
This question has also been asked and answered here: SSRIs vs SNRIs - What's the difference between them?
7 Answers
Debs21uk
14 Oct 2016
I recently started venlafaxine, cross tapered from citalopram so on a starting dose of 75mg for two weeks.
When you increase your dose does it take the standard 4-6 weeks for any improvements to come through? Is this a more potent drug?
eugeniabliss70
12 Aug 2016
there are definitely more side effects coming off SNRIs whenever I forget to take it for a day I get nauseous and dizzy. Three days without it because I stupidly run out of meds leaves me unable to drive, get very dizzy and my husband says I look like a junkie with dark circles under my eyes. Other than that, SNRIs are great! I tried 2 different SSRIS but did nothing for me and gave me no grief at all when I came off them.
I wouldn't trade my venlafaxine for anything though. It helps me feel normal and myself again. Before meds, I tried everything under the sun healthy eating, yoga, meditation you name it. It helped but nothing compares to being on the right meds. It turns out the depression runs in the family, sadly my daughter also has a bipolar diagnosis. My shrink said that it was a hyper expression of depression.
Luckily we are both doing great on the right meds.
KarlJones
21 June 2016
Hey Group! When you switched from ssri to snri's was there a waiting period or did you go from one to the other the next day?
MeggieGirl
21 June 2016
I typically do a step-down approach of the one drug, titrating down over one-to-two weeks; and during that same period of time, I do a step-UP approach, titrating up the new drug over the same period so, by the time approximately two weeks have passed, I have fully transitioned over to the new medication with no side effects from depleting myself of the old medication.
Seve72
2 Nov 2015
SSRI, work on the serotonin levels in your brain, the serotonin medication acts as a blocker between your brain synapses, meaning the serotonin stays in the synapse thus balancing mood! SNRI's, do the same as above but also act on the norepinephrine synapse! I was taking Seroxat for 26 yrs which is an SSRI, and have recently switched to cymbalta! Do not use Paroxetine, I've had major issues, use Cymbalta please heed my advice! Use the SNRI...
warden35
4 Jan 2017
Your answer/statement could be counter productive. SSRI's may not work for you but that does not mean they won't work for others. There are so many other factors that determine whether a specific drug will work or not for people that have either depression or bipolar.
Kewallace
6 Sep 2015
I can testify to Effexor!! It saved my life as well!!
If I forget a day or two though I become very mentally and emotionally unstable as well as being very light headed. Again, It's only if I forget, which is silly. Day by day though it is wonderful. I've tried SSRIs before (Wellbutrin, fluoxetine, and one other I forget the name of) and they really did nothing for me.
If you want to switch tell your doctor that you're interested in a SNRI. It may not be Effexor, because of course everyone is different, but the different class will probably help
sara12345
28 March 2014
Excellent answer above. It sounds like you must be unhappy with your current antidepressant. SNRIs can be brutal to get off, but that seems to be only if you get off of them very quickly, so that might be why your therapist made her comments about it. A couple friends of mine got off of Effexor (an SNRI) very quickly without any problems. My mother's dosage got lowered by mistake and she became psychotic which was quickly reversed once she got back on her proper dosage. I have been off of Effexor twice which I did very gradually without any problems. So if you feel you need more help, you could change to an SNRI, but just know that you WILL have to be careful if you decide to get off of it. But I can tell you that Effexor has literally saved my life. I have been extremely happy with it, and now take the upgraded version, Pristiq, which doesn't have the sexual side effects. Good luck.
sovereign_72
13 Jan 2016
Hello Sara. Thank you for your insight. I was on Lexapro for 3 years for anxiety and sporadic depression, came off it for 4 months and crashed and burned big time. I have just started Pristiq having 4 days on 25mg and today started 50mg. I guess I am struggling with the thoughts of "will this work", "will it increase my motivation", "will I feel excitement, joy, happiness again?", "will the irrational fears slow down or stop?". Just wondering what your experiences have been? Thanks
sara12345
13 Jan 2016
Not sure why you crashed and burned after stopping the Lexapro and you don't say why you stopped it. When I went off the Effexor gradually, I had no side effects from going off of it, but I did go back to a severe depression. I need to take anti-depressants for the rest of my life, which my doctor had told me. But of course, I had to find out for myself. And the doctor said that the more you go off of anti-depressants, and then go back onto them, it is more difficult for the anti-depressants to work, meaning that you may need higher doses. But it doesn't sound like you've been doing that. You will probably need a good month to 6 weeks to see if the new antidepressant will work. I would be interested in how it works for you. I wish you the best.
Ingenue
13 Jan 2016
Thank you for the nice greeting you sent me. Also because of reading this I now know what my remeron is, I think it's an SNRI, when My doctor
Cut my dosage in half, I became very nervous and nauseated. He put me back on the original dosage, and I recovered. My pharmacist found it strange, encourages me to cut it because it causes weight gain. However, I never want to go through that horrible withdraw, or whatever it was, again. So I'm cutting it down on my own, slower, less drastic. I hope that works! It is the first time I ever had that kind of reaction to 'any'
Reduction before. It was horrible, and lasted at least one and a half months.
sara12345
14 Jan 2016
I just saw your comment here. I'll need to change my message on the other question. I looked it up and Remeron is not an SNRI, so I don't know that you need to go off of it so slowly. I did look up side effects from Remeron vs. Effexor which is an SNRI. Yes, Remeron has potential side effect of weight gain, whereas Effexor has the opposite--possible loss of appetite. And while SNRI can be difficult to reduce for many people. Not everyone. Two of my friends were able to get off of it easily. If weight is such a problem, perhaps you should instead change to Effexor or its upgraded version Pristiq which does not have the sexual side effects. But I think that it may be that you need the full dose. You will find out. Good luck to you. Antidepressants can be difficult.
masso
27 March 2014
The biggest difference between an SSRI and an SNRI has to do with neurotransmitters. Experts believe that depression occurs when brain chemicals called neurotransmitters become unbalanced. Antidepressant drugs attempt to bring these neurotransmitters back into balance and alleviate the symptoms of depression.
Although the exact cause is not known, three neurotransmitters have been identified as being related to depression. Studies showed imbalances in dopamine, norepinephrine, and serotonin in patients with depression. An SSRI and an SNRI both affect absorption of serotonin, but an SNRI also affects norepinephrine levels in the brain.
Another difference between an SSRI and an SNRI is chronological. SSRIs were the first breakthrough drug for treating depression, and this type of medication is still widely used. SNRIs are more recent and may reflect more progressive research into the brain chemistry of depressed individuals.
LaurieShay
27 March 2014
Way to go Masso!! That was excellent.
masso
27 March 2014
Thank you Laurie!
Emeraldgirl
27 March 2014
Hello masso- well explained- take care
fayfaith
29 April 2014
Thank you Masso, for sharing, we all need as much knowledge as we can consume. :)
peterk312
14 Feb 2016
Above is written: "Experts believe that depression occurs when brain chemicals called neurotransmitters become unbalanced. Antidepressant drugs attempt to bring these neurotransmitters back into balance ... " -- As stated this is 100% false. No psychiatric drug that inhibits the reuptake of a neurotransmitter is "restoring" a balance. The drug is causing an imbalance. Moreover, because serotonin stays active in the synapse between neurons in a very unnatural way it affects other neurotransmitters. This is one reason people taking these drugs have side effects like an inability to sleep, nervousness, impulsive behavior, etc. The fact that certain people (especially the elderly) are at risk for serotonin syndrome after taking SSRI or SNRI type drugs is enough proof that to say "Antidepressant drugs attempt to bring these neurotransmitters back into balance... " is misinformation.
You are only parroting what you've heard through advertisements and the simplified but still distorted perspective spread by some health professionals. The "cause" of depression is multifactorial, and physiology is most often a correlated factor that is bidirectional with things like environmental factors (bad events, poor living conditions, interpersonal conflicts, access to good nutrition, etc.) Physiology can affect behavior, but environmental conditions affect behavior too. This understanding of depression being caused only by "chemical imbalances" is nothing but biodeterminism.
LaurieShay
14 Feb 2016
Interesting perspective and arguably so. The physiology of the neurotransmitters and receptors is complex to say the least. Depression is a mental health condition that has both physiological and environmental components. Neither of which can be ignored when treating the illness.
masso
15 Feb 2016
Hey peterk312 , and you are one of those persons who believe you know it all and if you think, you know you are not worth my time.
Windchimes123
15 Oct 2016
But how do they decide which one to start you on for straight forward depression??
I just have to work on being happy and I'm too sensitive.
I've tried various ones but they don't seem to work.
Thanks
LaurieShay
15 Oct 2016
They usually start you on a SSRI before an SNRI since SSRI's affect serotonin while SNRI's affect serotonin and norepinephrine. If the SSRI doesn't work, they may progress to trying an SNRI.
Windchimes123
15 Oct 2016
Thanks, Laurie,
Too bad it takes months of observing to decide the best one.
You gave a nice precise explanation.
Windchimes123
16 Oct 2016
Does anyone remember when any psych meds were only prescribed by psychiatrists?
It was a big deal when Primaries felt prescribing because they took CMEs and taught by drug reps.
Cost effective ? Sure ... for insurance and patients.
If we are going to argue, I'd love to hear if you all feel we have progressed or taken a step backwards in caring for these issues ?
Inquiring minds want to know. :)
Related topics
cymbalta, zoloft, depression, anxiety, obsessive compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, norepinephrine, ssri, serotonin-norepinephrine reuptake inhibitors
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