How do SNRIs help anxiety? (Depression too.)

[JackiesBabyy]

What exactly is NE's role in depression(or certain types of depression)?

And, since SNRIs are sometimes prescribed for anxiety too, this is where I'm really confused. I can kind of see NE helping depression by being involved in alertness/fight-or-flight, but why does it help anxiety? SNRIs (if I'm correct) increase NE levels in the brain and, since NE is the main cause of anxiety, why would more NE be of benefit?

Edit: Meant to post this in ADD, sorry. If anyone here knows feel free to answer anyway.

 

[deficiT]

SNRI's can also increase dopamine levels in the brain, which could possibly help a little with anxiety. And possibly having more adrenaline in the body could make you more confident, conquering anxiety. Thats the best I got though

 

[Thou]

They didn't do anything but provide me with a false sense of security for a few months at which point I was already addicted and am still suffering protracted withdrawal symptoms and sexual dysfunction ten years later after stopping abruptly at my doctors order. I was 15 when first put on effexor, been on and off a few others, tapered slowly last time around, and still have complications from their use.

Whatever neurological effects on our transmitters they have, however interesting, aren't helping depression at all, quite the contrary. Exacerbation.

In my opinion.

Experience with: Effexor, Pristiq, Lexapro, Cymbalta, etc.

 

[deficiT]

I hear you on the false sense of security. Deep down I don't know why I choose to use the things. I guess its the sense of security. Your doctor made you stop abruptly? No tapering at all? That's kind of fucked up.

 

[JackiesBabyy]

They didn't do anything but provide me with a false sense of security for a few months at which point I was already addicted and am still suffering protracted withdrawal symptoms and sexual dysfunction ten years later after stopping abruptly at my doctors order. I was 15 when first put on effexor, been on and off a few others, tapered slowly last time around, and still have complications from their use.

Whatever neurological effects on our transmitters they have, however interesting, aren't helping depression at all, quite the contrary. Exacerbation.

In my opinion.

Experience with: Effexor, Pristiq, Lexapro, Cymbalta, etc.

Horror stories like this is why I'm too scared to try Zoloft (not an SNRI but still), despite the fact it might help my atypical depression and social anxiety majorly. (I find it rather amusing I've heavily abused RC stims, 4-FA and 2-FMA, and yet am too scared to take a drug with years of research behind it that you can get from any doctor)

I hear you on the false sense of security. Deep down I don't know why I choose to use the things. I guess its the sense of security. Your doctor made you stop abruptly? No tapering at all? That's kind of fucked up.

That IS fucked up, and more than enough reason to find a new doctor.

 

[Sepher]

JackiesBaby, from my very limited understanding ( with the aid of The Google for the dopamine bit! ) it's not the noradrenergic component that's targetting anxiety. The noradrenergic component is primarily aimed at symptoms like anhedonia, lack of attention, motivation, loss of interest, etc. It's mainly the serotonergic component that is targetting irritability and anxiety. Increased noradrenaline though might increase dopamine levels in the frontal cortex because dopamine inactivation there is via the noradrenaline transporter, and though dopamine's primarily linked to pleasure and motivation it may have an effect on anxiety also.

 

[Swimmingdancer]

Edit: Meant to post this in ADD, sorry. If anyone here knows feel free to answer anyway.

I'm not sure if ADD is necessary, maybe OD? I can move it if you like.

 

[OrLackThereof]

I've been on a fairly decent list of psych meds. Several SSRI's (Lexapro, Paxil, etc), Cymbalta which is an SNRI, Seroquel which is an atypical antipsychotic...

I never managed to stay on them for very long because I have a unique brain chemistry from having a schizophrenic father and bipolar mother...can't get benzos, so...
I
But to the point, SSRI's made me brutally drowsy so I went with Cymbalta which helped to a point, except the sexual dysfunction but thats shared with almost all of the reuptake inhibitors. Seroquel helped my anxiety immensely but left me with major lethargy. Everyone reacts differently and I am far from typical but those are my experiences,for what little it's worth.

So, in my experience:
SSRI- GREAT for depression if you find the right med. Just okay for anxiety. Sexual dysfunction and drowsiness pretty likely. Also a ”forced yawn” is an odd side effect shared with some SNRI's.
SNRI- Okay for depression, good for anxiety. A reasonable option if you responded well to an SSRI but the drowsiness was a problem.

Antipsychotics and Atypicals-Good for everything if you have treatment-resistant issues, but they are LADEN with side effects especially extra-pyramidal which is extremely uncomfortable and unnerving.

 

[missmegandelaney]

I take Celexa for anxiety.
I also take trazadone to sleep (a high dose of it but thats because I can't fall asleep ever.)
Doctors always say it's a lovely combo.

 

[Supeudol]

I take Celexa for anxiety.
I also take trazadone to sleep (a high dose of it but thats because I can't fall asleep ever.)
Doctors always say it's a lovely combo.

Yeah, Trazodone is awesome for sleep. Much better than Benzo's or Z-Drugs. I'm already on 40mg/day of Diazepam, as well as HydroMorphContin 30mg TID (although I don't usually take a full 90mg in one day, and I usually use the HydromorphContin Intranasally after they been crushed up really good because its got a much better B/A insufflated than Oral. )

But lots of times, I can't get to sleep without Trazodone. But sometimes I just take half of a 100mg tablet and that does me good.

But people with insomnia should really give Trazodone a shot before they start using a benzo or a Z-Drug for sleep every night.

 

[Geaux Tigers!]

Take the SNRI venlafaxine (Effexor). You have SERT and NE activity as stated previously.

SERT activity is similar to the TCAs Desipramine/Nortriptyline. Desipramine is almost an NRI of the TCAs while nortriptyline has more serotonegic properties; therefore, you are getting the 5-HT mechanism of anxiety relief with venlafaxine.

In fact, venlafaxine blocks the reuptake of SERT greater than that of NE.

I would say that venlafaxine is akin to adding desipramine to a very weak SSRI. The TCA mechanism is concomitant with a SSRI mechanism in terms of anxiety relieving mechanisms.

Also, you must think that just because you have more NE in the synapse doesn't mean that it is giving you the typical "flight-or-fight" response; it is likely affecting serotonin via upstream firing induced by NE release.

This is all in lower doses <150mg. In higher doses, the NE does have more affect and this may increase motivation, etc.

There is evidence that venlafaxine acts on opiate receptors as well but I'm not sure how clinically relevant this is.

I used my own brain on this ^^ but there are two useful articles I dug up after writing this that you might find interesting.

Venlafaxine: Discrepancy between in vivo 5-HT and NE reuptake blockade and affinity for reuptake sites

Neurotransmitter Receptor and Transporter Binding Profile of Antidepressants and Their Metabolites