What are the common side effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?

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From the Guidelines

Common side effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) include nausea, vomiting, diarrhea, dizziness, headache, insomnia, and somnolence.

Adverse Effects of SNRIs

The following are some of the common side effects associated with SNRIs:

  • Diaphoresis
  • Dry mouth
  • Abdominal discomfort
  • Nausea
  • Vomiting
  • Diarrhea
  • Dizziness
  • Headache
  • Tremor
  • Insomnia
  • Somnolence
  • Decreased appetite
  • Weight loss as described in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1.

Severe Adverse Events

Some severe adverse events associated with SNRIs include:

  • Suicidal thinking and behavior (through age 24 years)
  • Behavioral activation/agitation
  • Hypomania
  • Mania
  • Sexual dysfunction
  • Seizures
  • Abnormal bleeding
  • Serotonin syndrome as reported in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1.

Individual SNRI Medications

Individual SNRI medications have also been associated with distinctive, potentially serious (albeit rare) adverse effects, such as:

  • Venlafaxine: greater suicide risk, overdose fatalities, and discontinuation symptoms
  • Duloxetine: hepatic failure, cholestatic jaundice, and severe skin reactions as described in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1. The most commonly reported adverse events were similar across different second-generation antidepressants, including SNRIs, with some differences in the incidence of specific adverse events 1.

From the Research

Common Side Effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

  • Nausea: a common side effect of SNRIs, with a higher risk compared to selective serotonin reuptake inhibitors (SSRIs) 2
  • Headache: a common side effect of SNRIs, with a prevalence of up to 17/1000 person-months of therapy in adults and adolescents 2
  • Sexual dysfunction: a common side effect of SNRIs, with a prevalence of up to 25.71% 3
  • Dizziness: a common side effect of duloxetine, a type of SNRI 4
  • Dry mouth: a common side effect of duloxetine, a type of SNRI 4
  • Constipation: a common side effect of duloxetine, a type of SNRI 4
  • Insomnia: a common side effect of duloxetine, a type of SNRI 4
  • Asthenia: a common side effect of duloxetine, a type of SNRI 4
  • Hypertension: a common side effect of duloxetine, a type of SNRI, and venlafaxine, another type of SNRI 4
  • Diaphoresis: a common side effect of venlafaxine, a type of SNRI, at higher doses 4
  • Tachycardia: a common side effect of venlafaxine, a type of SNRI, at higher doses 4
  • Tremors: a common side effect of venlafaxine, a type of SNRI, at higher doses 4
  • Anxiety: a common side effect of venlafaxine, a type of SNRI, at higher doses 4
  • Dysuria: a common side effect of milnacipran, a type of SNRI, occurring in up to 7% of patients 4
  • Blood pressure and pulse elevations: a common side effect of milnacipran and levomilnacipran, types of SNRIs, at high doses 4

Serious Side Effects of SNRIs

  • Serotonin syndrome: a potentially life-threatening condition that can occur when SNRIs are combined with monoamine oxidase inhibitors (MAOIs) 5, 4
  • Intraoperative bleeding: a potentially increased risk related to the continuation of SNRIs through the perioperative period 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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