Background | Venlafaxine | Duloxetine
Although the SSRIs have major advantages over the TCAs, particularly
with respect to safety and tolerability, a medication that has actions
not only on serotonin but also on norepinephrine may have some advantages.
For example, some authors have suggested that dual reuptake inhibitors
may be more likely to lead to remission (Thase et al. 2001).
Serotonin–norepinephrine reuptake inhibitors (SNRIs) are
dual reuptake inhibitors that affect serotonin and norepinephrine but
have little effect on muscarinic, H1,
receptors. Thus, these medications share many of the tolerability
and safety benefits of the SSRIs but add an additional pharmacological
action compared with SSRIs—namely, norepinephrine reuptake
inhibition. Two SNRIs are currently available in the United States:
venlafaxine and duloxetine.