Moody Blues – Depression 103: Treatment with SNRIs

June 20, 2018

SNRIs or serotonin-norepinephrine re-uptake inhibitors are effective treatments for many types of depression

Ever get the moody blues so bad that you just can’t make it go away? You may be a candidate for treatment with medications called serotonin-norepinephrine re-uptake inhibitors or SNRIs!

When depression is persistent and the gloomy cloud associated with it persist, physicians employ a variety of diagnostics and treatments to improve mood and sense of well-being.

Instruments used to gauge the extent and depth of depression are commonly utilized in patient care experiences. The PHQ-9 and GAD-7 help healthcare professionals better understand the dynamics, and the possible association of anxiety as a component of the mood disorder.

When it comes to treatment, exercise, healthy food, adequate rest, avoidance of drugs, alcohol and stress comprise critical adjuncts to therapy. Cognitive behavioral therapy or counseling is often employed, and is an important modality as well.

Sometimes, medications are recommended. Medications work to restore the balance of feel-good hormones serotonin, norepinephrine and dopamine that I discussed in Depression 101.

One such class of medications are the serotonin-norepinephrine re-uptake inhibitors or SNRIs. You may know them as Effexor, Pristiq and Cymbalta. Unlike, Prozac, Zoloft and Celexa the serotonin norepinephrine re-uptake inhibitors restore the balance of both serotonin and norepinephrine in the nervous system. Sometimes, unfortunately the added benefit comes with more side effects. For example, SNRIs should only be used during pregnancy when depression is refractory and associated with suicidal ideation.

Cymbalta, also known as duloxetine, can be used to treat peripheral neuropathy in conjunction with other medications as an added benefit.

Like the SSRIs, serotonin norepinephrine re-uptake inhibitors are likely to cause weight gain and they are expensive, so marginal benefits may not be worth the high costs.

Also, beware of this, for reasons not at all understood, utilization of SNRIs in young adults is associated with an increase incidence of suicide, so they must be used with caution in that age group.

This is Dr. Jim for Be Healthy! Be Happy! Power your path to happiness and look forward to Depression 104 where I discuss Wellbutrin, another effective medication for the treatment of refractory depression.