Taking SNRIs for Treating Panic Disorder

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Often prescribed to treat mood and anxiety disorders, serotonin and norepinephrine reuptake inhibitors are one of the most common treatment 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 include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine). These antidepressants are frequently prescribed to treat mood disorders, such as major depressive disorder and depression in bipolar disorder.

SNRIs have also been found to safely and successfully treat anxiety disorders, including panic disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). Additionally, SNRIs can also effectively treat persistent pain caused by certain conditions, such as fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

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 neurotransmitters serotonin and norepinephrine are 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 the fight-or-flight response.

SNRIs work to influence both serotonin and norepinephrine by preventing a person’s brain cells from rapidly absorbing these neurotransmitters. By stabilizing these neurotransmitters, SNRIs can help improve a person’s mood, reduce feelings of anxiety, and help alleviate panic attacks.

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

Side Effects

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

  • Nausea or vomiting
  • Dry mouth
  • Drowsiness and fatigue
  • Headaches
  • Sexual side-effects
  • Increased nervousness
  • Upset stomach or abdominal pain
  • Sleep disturbance

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 other antidepressant medications may lead to heightened suicidal thoughts and behaviors, particularly in young people.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for 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 our National 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. 

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