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serotonin & norepinephrine reuptake inhibitor (SNRI, dual-acting reuptake inhibitor)
Indications:
- depression
- obsessive compulsive disorder (OCD)
- anxiety disorder [2]
* modestly better than placebo for treating depression, OCD, anxiety in children & adolescents [2]
* SNRI benefit for anxiety in children limited to clinician- reported, not child- or parent-reported symptoms [3]
* patients with depression & anhedonia, abulia, fatigue, or psychomotor retardation receive treatment with an SNRI rather than SSRI [4]
Mechanism of action:
- inhibits reuptake of both serotonin & norepinephrine
Interactions
drug interactions
drug adverse effects (more general classes)
Related
selective serotonin reuptake inhibitor (SSRI)
Specific
desvenlafaxine; norvenlafaxine; N-desmethylvenlafaxine (Pristiq)
duloxetine (Cymbalta, Yentreve, Drizalma Sprinkle)
milnacipran (Savella)
tramadol (Ultram)
venlafaxine (Effexor XR)
General
atypical antidepressant
References
- Prescriber's Letter 11(9): 2004
Detail-Document#: 200901
(subscription needed) http://www.prescribersletter.com
- Locher C, Koechlin H, Zion SR et al
Efficacy and Safety of Selective Serotonin Reuptake Inhibitors,
Serotonin-Norepinephrine Reuptake Inhibitors, and Placebo for
Common Psychiatric Disorders Among Children and Adolescents.
A Systematic Review and Meta-analysis.
JAMA Psychiatry. Published online August 30, 2017.
PMID: 28854296
http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2652447
- Merry SN, Hetrick SE, Stasiak K.
Effectiveness and Safety of Antidepressants for Children and
Adolescents. Implications for Clinical Practice.
JAMA Psychiatry. Published online August 30, 2017.
PMID: 28854300
http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2652446
- Wang Z, Whiteside SPH, Sim L et al
Comparative Effectiveness and Safety of Cognitive Behavioral
Therapy and Pharmacotherapy for Childhood Anxiety Disorders.
A Systematic Review and Meta-analysis.
JAMA Pediatr. Published online August 31, 2017.
PMID: 28859190
http://jamanetwork.com/journals/jamapediatrics/fullarticle/2650801
- Asarnow JR, Rozenman MS, Carlson GA
Medication and Cognitive Behavioral Therapy for Pediatric Anxiety
Disorders. No Need for Anxiety in Treating Anxiety.
JAMA Pediatr. Published online August 31, 2017.
PMID: 28859188
http://jamanetwork.com/journals/jamapediatrics/fullarticle/2650800
- Bennabi D, Charpeaud T, Yrondi A et al
Clinical guidelines for the management of treatment-resistant depression:
French recommendations from experts, the French Association for Biological
Psychiatry and Neuropsychopharmacology and the fondation FondaMental.
BMC Psychiatry. 2019 Aug 28;19(1):262.
PMID: 31455302 PMCID: PMC6712810