If you’ve ever talked to your doctor about depression or anxiety, chances are you’ve heard of SSRIs and SNRIs. But what do these acronyms actually mean? More importantly, what’s the difference between SSRI and SNRI medications, and how do you know which one is right for you?
What Are SSRIs?
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They work well for many people and tend to have fewer side effects than older antidepressants or SNRIs.
How Do SSRIs Work?
Serotonin is one of your brain’s “feel-good” chemicals, a neurotransmitter that helps regulate mood, emotions, and sleep. Your brain naturally absorbs or “reuptakes” serotonin after it’s used, but SSRIs prevent this reuptake, keeping more serotonin available. The result is a boost in mood and relief from anxiety and depression symptoms.
SSRI Examples
You probably recognize the names of several SSRIs:
- Fluoxetine (Prozac) is one of the most well-known antidepressants. It has a longer half-life than most SSRIs, meaning it stays in the body longer and has a lower risk of withdrawal symptoms.
- Sertraline (Zoloft) is known for its effectiveness in treating a wide range of mental health conditions. However, it can sometimes cause mild stomach upset, especially when first starting the medication.
- Citalopram (Celexa) is typically well-tolerated, but it has been associated with dose-dependent effects on heart rhythm. Because of this, doctors often limit the dosage, particularly for older adults or those with heart conditions.
- Escitalopram (Lexapro) is often praised for having fewer side effects while maintaining strong effectiveness. Many patients find it easier to tolerate, with less drowsiness or weight gain than other SSRIs.
- Paroxetine (Paxil) is sometimes favored for its sedative properties. However, it also has a higher likelihood of withdrawal symptoms, so doctors recommend tapering off gradually.
What Are SNRIs?
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs but with one key difference: they also increase norepinephrine levels, another neurotransmitter that affects mood, attention, and energy.
How Do SNRIs Work?
While serotonin is great for mood regulation, norepinephrine helps with focus, alertness, and pain perception. That means SNRIs don’t just help with depression and anxiety—they can also be effective for chronic pain conditions and fatigue.
SNRI Examples
Their names might not be as widely known, but SNRIs can still do the job. Here are some examples:
- Venlafaxine (Effexor XR) regulates mood while providing an energizing effect for some patients. It can raise blood pressure at higher doses, so regular monitoring is necessary.
- Desvenlafaxine (Pristiq), a close relative of Effexor, is more predictable in the body, offering a smoother response and fewer blood pressure fluctuations.
- Duloxetine (Cymbalta) helps stabilize mood and relieve pain but may cause nausea when first starting.
- Levomilnacipran (Fetzima) is a newer SNRI. It has a stronger effect on norepinephrine than serotonin, making it particularly energizing. Because of this, it may be a good choice for those struggling with fatigue and poor motivation.
What Conditions Do They Treat?
You might wonder how your doctor decides whether to prescribe an SSRI or SNRI. It depends on the condition being treated. If pain is a major factor, SNRIs might be the right choice. Otherwise, SSRIs could be the way to go, especially since they have fewer side effects.
SSRIs are commonly used for:
- Major depressive disorder
- Generalized anxiety disorder
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD)
- Bulimia
- Hot flashes
SNRIs are commonly used for:
- Major depressive disorder
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Chronic muscle or joint pain
- Fibromyalgia
- Diabetic neuropathy
SSRI vs. SNRI Side Effects
No medication is perfect, and both SSRIs and SNRIs come with possible side effects.
Common SSRI side effects include:
- Nausea or vomiting
- Digestive troubles
- Headaches
- Dry mouth
- Insomnia or drowsiness
- Weight gain
- Sexual dysfunction
Common SNRI side effects include everything listed above, plus:
- Increased blood pressure
- Elevated heart rate
- Excessive sweating
Are SNRIs Better Than SSRIs?
There’s no one-size-fits-all answer. The best medication is the one that works for you and has the fewest side effects. When deciding to prescribe an SSRI or SNRI, your doctor will consider several factors, including:
- Your specific symptoms: Are you just dealing with depression and anxiety, or is pain and fatigue a factor, too?
- Your medical history: Do you have high blood pressure or heart problems?
- Past medication experiences: Have you tried an SSRI before? Did it work?
- Side effect tolerance: Are you okay with potentially increased perspiration and a higher heart rate?
Finding the right antidepressant involves some trial and error. Some people respond well to SSRIs, while others do better with SNRIs. Both types of medications can take several weeks to provide noticeable improvement in your symptoms, so don’t give up prematurely. The key is patience and open communication with your healthcare provider.
One common issue is the loss of effectiveness after months or years on the same medication caused by the brain developing a tolerance to the drug. Recommendations for combating this include increasing the dose or switching to another antidepressant that works differently.
MindWell Urgent Care Can Help
Choosing between an SSRI and SNRI can feel overwhelming, but you don’t have to figure it out alone. MindWell Urgent Care is a mental health urgent care provider with urgent appointments available—no waiting months for the help you need. Our board-certified providers take a patient-centered approach, ensuring you get the right medication for your unique needs. If you’re in Dallas, TX, consider an in-person appointment at our location off of N Stemmons Freeway. You can also schedule a virtual visit if you live anywhere in Texas, Oklahoma, New Jersey, Florida, or Kansas. Ready to take the next step toward feeling better? Contact us today—we’re here to help.