SNRIs Mini Quiz

Question 1

What are SNRIs?

Answer 1

SNRIs are antidepressants that work by blocking the reuptake of both serotonin and norepinephrine

Serotonin (5HT) affects mood, sleep, appetite, and calmness, while norepinephrine (NE) affects alertness and energy.

Question 2

What is the result of SNRIs blocking the reuptake of serotonin and norepinephrine?

Answer 2

More serotonin and norepinephrine stay in the synapse, leading to a mood boost and increased energy.

Question 3

How can SNRIs be analogously described?

Answer 3

SNRIs can be thought of as ‘Double Boosters’ where one arm lifts mood and the other lifts energy.

Question 4

List common SNRI medications.

Answer 4

• Venlafaxine (Effexor XR)
• Duloxetine (Cymbalta)
• Desvenlafaxine (Pristiq)
• Levomilnacipran (Fetzima)

Question 5

What are the indications for SNRIs?

Answer 5

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)
• Chronic pain (especially Cymbalta)
• Fibromyalgia (Cymbalta approved)
• Diabetic neuropathy (Duloxetine)

Question 6

What is the simplified mechanism of action for SNRIs?

Answer 6

SNRIs block the reuptake pump, allowing serotonin and norepinephrine to remain in the synapse longer, boosting their effect.

Question 7

What are common side effects of SNRIs?

Answer 7

• Increased blood pressure (especially venlafaxine)
• Anxiety or insomnia
• Sexual dysfunction
• GI upset
• Sweating
• Discontinuation syndrome (especially venlafaxine if stopped suddenly)

Question 8

What are the SNRI red flags?

Answer 8

• Watch blood pressure regularly
• Don’t stop abruptly to avoid withdrawal symptoms
• Risk of serotonin syndrome if combined with other serotonergic drugs
• Suicide risk in children/adolescents (Black Box Warning)

Question 9

What does the mnemonic ‘SNRIs: Some Nerves Recharge Instantly’ stand for?

Answer 9

• Serotonin
• Norepinephrine
• Reuptake
• Inhibitor

Question 10

What is the main difference between SNRIs and SSRIs?

Answer 10

SNRIs target both serotonin and norepinephrine, while SSRIs target serotonin only.

Question 11

What are the effects of SNRIs on blood pressure?

Answer 11

SNRIs can raise blood pressure, unlike SSRIs which have a neutral effect.

Question 12

What should be done when tapering off SNRIs?

Answer 12

NEVER stop abruptly; taper slowly over 2+ weeks, especially with venlafaxine.

Question 13

Fill in the blank: Discontinuation feels like _______.

Answer 13

brain zaps, nausea, irritability, dizziness.