🌊 SNRIs – Serotonin–Norepinephrine Reuptake Inhibitors


What they are:

SNRIs are antidepressants that increase two brain chemicals: serotonin and norepinephrine. They can help with anxiety, depression, and certain pain conditions.


Common examples:

• Duloxetine (Cymbalta)

• Venlafaxine (Effexor)


Uses in kids and teens 🧠

• Duloxetine is FDA-approved for Generalized Anxiety Disorder (GAD) in children 7–17 years old.

• Sometimes used (off-label) for depression or chronic pain when other medications aren’t enough.


How they work:

SNRIs block the “reuptake pumps” for serotonin and norepinephrine, helping nerve cells communicate more steadily. Norepinephrine is tied to alertness, focus, and the body’s stress response – boosting it slightly can improve energy and concentration.


Stats & facts 📊

• In U.S. adolescents, antidepressant use (mostly SSRIs, some SNRIs) sits around 4–5%, and SSRIs are usually tried first.

• Evidence shows duloxetine improves anxiety scores more than placebo in youth with GAD.


Common side effects:

• Nausea, dry mouth

• Sleep changes (tiredness or insomnia)

• Headaches

• Increased sweating

• Sometimes a temporary increase in anxiety in the first weeks


Safety notes for families ⚠️

• Like SSRIs, SNRIs carry the suicidality black-box warning in people under 25. Families should watch for new agitation, dark thoughts, or behavior changes and contact the prescriber right away.

• SNRIs can raise blood pressure or heart rate in some people, so doctors may check vitals regularly.


References (SNRIs):

• Dwyer, J. B., et al. (2019). Antidepressants for pediatric patients. Child and Adolescent Psychiatric Clinics.

• U.S. FDA. (2020). CYMBALTA (duloxetine) label – Pediatric GAD indication.