SNRIs – Test Prep and Practice Pearls
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist
4.9 • 773 Ratings
🗓️ 4 June 2026
⏱️ 15 minutes
🧾️ Download transcript
Summary
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that increase serotonin and norepinephrine levels in the brain. Common agents include venlafaxine (Effexor XR), desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and milnacipran (Savella). In addition to treating depression and anxiety disorders, several SNRIs have important pain indications, making them especially useful in patients with neuropathy, fibromyalgia, or chronic musculoskeletal pain. Common adverse effects include nausea, sweating, insomnia, sexual dysfunction, and elevated blood pressure. Clinicians should also remember the significant discontinuation risk associated with shorter half-life agents like venlafaxine and desvenlafaxine.
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Transcript
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| 0:00.0 | Hey all, welcome back to the Real Life Pharmacology podcast. I am your host, pharmacist, Derek Christensen. |
| 0:05.9 | Thank you so much for listening today. Today I'm going to cover those test prep pearls, as well as things that happen out in practice for the SNRIs. |
| 0:17.0 | Before we get into that, reminder, go to real-life pharmacology.com. |
| 0:21.6 | Get your free 31-page PDF on the top 200 drugs. |
| 0:26.2 | Great study guide, great refresher, whether you're out in practice |
| 0:28.9 | or whether you're preparing for board exams. |
| 0:31.9 | So go take advantage of that. |
| 0:33.9 | Simply an email will get you access to that. |
| 0:36.2 | Again, do that at real-life pharmacology.com. |
| 0:40.2 | All right. So just a little bit of background, SNRIs. |
| 0:44.8 | That stands for serotonin and norapinephrine reuptake inhibitor. |
| 0:50.3 | Essentially, they increase serotonin and noraponephrine in the central nervous system. |
| 0:56.4 | There's going to be, you know, obviously quite a few overlapping adverse effects to SSRIs |
| 1:03.1 | because these drugs increase serotonin. |
| 1:07.6 | But on the flip side, we've got some norapinephrine effects as well. And you'll kind of see how |
| 1:13.0 | that plays out as I get into the agents specifically. I would say from a general standpoint, where you're |
| 1:22.1 | more likely to see these medications use compared to the SSRIs. First and foremost, if there's |
| 1:30.7 | coexisting pain syndromes, fibromyalgia, neuropathy, for example, in association with |
| 1:39.2 | depression and anxiety, or kind of a comorbid condition there with depression or anxiety. |
| 1:46.5 | Also, having that noraphenephyrine effect, |
| 1:49.9 | these may be a little bit more stimulating for some patients. |
| 1:53.5 | So if somebody really struggles with a ton of fatigue, |
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