SNRI medications for depression and anxiety - online prescription available

SNRIs (serotonin-norepinephrine reuptake inhibitors) are a type antidepressant medication used to treat depression, anxiety, and other conditions. Talk to one of our doctors online to discuss if SNRIs are right for you.*

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Can contribute to increased energy and motivation

Used to treat various conditions, including depression and anxiety

Discuss mental health concerns and get evaluated for SNRIs in a private and secure virtual environment by a top-rated physician

*Please note that at this time, PlushCare does not have psychiatrists. However, our primary care physicians can diagnose, manage, and treat many mental health conditions and refill certain mental health medications after a qualifying evaluation. Prescriptions are provided at the doctor’s discretion. Learn more about our controlled substances policy and how to save up to 80% with our prescription discount card

SNRI medication prescriptions online for anxiety and depression

The convenience of a qualified online doctor to treat depression, anxiety, or other mental health disorders can make all the difference. Mental health struggles are treatable, and seeking help is a sign of strength. With the proper support and treatment, people with mental illness, including those with depression and anxiety, can lead fulfilling and healthy lives. 

With online mental health care, you can avoid the stress of sitting in traffic, trying to get time off work or school, risking getting sick in the doctor’s office, or struggling to get an appointment with an overbooked provider. Our virtual doctor visits are designed to get you the mental health help you need quickly and conveniently so you can focus your energy on your treatment plan. Schedule follow-up visits, get prescription refills, get a second opinion, or simply talk to a doctor or therapist at a time and place that suits you.

When under treatment with SNRIs, it’s essential to have regular, ongoing visits with your doctor to ensure the correct dose and treatment plan. Everyone responds differently, and it might be necessary for your doctor to change your prescription based on how you respond to your depression or anxiety treatment.

Uses of SNRI medications

SNRIs are FDA-approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder. SNRIs are also approved for managing conditions such as fibromyalgia and chronic musculoskeletal pain. They can also be used to treat peripheral neuropathy and for pain management, and they can even work for obsessive-compulsive disorder (OCD).

  • Depression

    SNRIs are effective in helping relieve symptoms of depression, such as persistent sadness, loss of interest in activities, and fatigue. SNRI treatment can help boost energy and bring back the ability to enjoy life and engage more actively in day-to-day tasks. SNRI medications can be part of a long-term treatment plan for depression, used alongside therapy and supportive lifestyle changes.

  • Anxiety

    SNRIs, with their impact on serotonin and norepinephrine, are commonly prescribed for anxiety disorders. Medications like venlafaxine and duloxetine have shown efficacy in managing symptoms of generalized anxiety disorder (GAD) and social anxiety disorder

  • ADHD

    SNRIs, particularly atomoxetine, are sometimes considered for attention-deficit/hyperactivity disorder (ADHD). While other medications are more common in ADHD treatment, SNRIs may be explored when they are not suitable. 

  • OCD

    OCD (obsessive-compulsive disorder) is typically treated with SSRIs, but SNRIs, like venlafaxine and duloxetine, may be considered in some instances.

  • Pain

    SNRIs are recognized for their pain-relieving properties. Duloxetine, in particular, is approved for managing chronic musculoskeletal pain and neuropathic pain associated with conditions like diabetic peripheral neuropathy and fibromyalgia.

  • Fibromyalgia

    Fibromyalgia, characterized by widespread musculoskeletal pain, may be addressed with SNRIs. Duloxetine is approved for this condition, providing relief and improving the overall quality of life for fibromyalgia patients. 

  • Nerve pain

    SNRIs are frequently utilized in the management of nerve pain. Medications like duloxetine are prescribed for conditions such as diabetic peripheral neuropathy, helping to alleviate pain associated with nerve damage.

    Remember that individual responses to medications vary, and treatment decisions should be made in consultation with a healthcare provider who can assess each patient's needs and circumstances.

How SNRI medications work

SNRIs, or serotonin-norepinephrine reuptake inhibitors, are classified as antidepressant treatments. By increasing the levels of neurotransmitters, or brain chemicals, called serotonin and norepinephrine, they help improve mood and reduce symptoms associated with depression.

SNRIs prevent the reuptake, or reabsorption, of neurotransmitters by the brain. By keeping serotonin and norepinephrine around longer, they help regulate mood and alleviate symptoms of depression and anxiety.

Unlike other classes of antidepressants, SNRI drugs target both serotonin and norepinephrine neurotransmitters, enhancing communication between nerve cells in the brain. By targeting both serotonin and norepinephrine reuptake, they can be more effective for a range of mental health conditions.

Commonly prescribed SNRI medications

  • Our experienced doctors at PlushCare frequently prescribe various SNRIs to address diverse patient needs, ensuring personalized and effective care. Several generic SNRIs are also available, which can be equivalent in efficacy to their brand-name counterparts but often more cost-effective.  

    • Venlafaxine (Effexor): Effexor (venlafaxine) is an SNRI that is often prescribed to treat depression, generalized anxiety disorder, panic disorder, and social anxiety. It works by increasing the levels of serotonin and norepinephrine in the brain. 

    • Duloxetine (Cymbalta): Cymbalta (duloxetine) is another commonly used SNRI indicated for conditions such as major depressive disorder, generalized anxiety disorder, fibromyalgia, and chronic musculoskeletal pain. 

    • Desvenlafaxine (Pristiq): Pristiq (desvenlafaxine) is an alternative to venlafaxine and is used to treat major depressive disorder. 

    • Milnacipran: Milnacipran is a generic form of Savella primarily used in the treatment of fibromyalgia. It functions by increasing the levels of serotonin and norepinephrine, potentially contributing to pain relief and improved mood. While it's an SNRI, it's not FDA-approved for the treatment of depression in the United States. 

    • Levomilnacipran (Fetzima): Levomilnacipran is indicated for the treatment of major depressive disorder. It is similar to milnacipran and inhibits serotonin and norepinephrine reuptake, but may have significant side effects including increased blood pressure so is often not a first or second choice for medications of this type. 

What are the pros and cons?



  • Effective treatment: SNRIs are effective in treating various mental health disorders, such as major depressive disorder, generalized anxiety disorder, and certain chronic pain conditions. 

  • Dual-action: SNRIs’ dual-action on serotonin and norepinephrine may enhance their mood-regulating effects. 

  • Widely prescribed: Doctors frequently prescribe SNRIs due to their versatility and efficacy. 

  • Reduced side effect profile: Compared to other classes of antidepressants, SNRIs are generally associated with fewer side effects. 


  • Potential side effects: Common side effects may include nausea, dizziness, insomnia, and changes in appetite. 

  • Withdrawal symptoms: Reducing the dosage or discontinuing SNRI treatment too rapidly can lead to withdrawal symptoms like dizziness, headache, fatigue, irritability, and flu-like sensations. 

  • Risk of bleeding: SNRIs may increase the risk of bleeding, especially when combined with other medications affecting blood clotting. It’s essential to inform your doctor about all medications you take. 

  • Individual variability: Responses to SNRIs can vary based on genetics, overall health, and specific conditions. 

SNRIs vs. other antidepressants

  • SNRIs vs. tricyclic antidepressants (TCAs)

    In comparison to tricyclic antidepressants (TCAs), SNRIs offer a more selective action on serotonin and norepinephrine. Doctors generally prefer SNRIs because they are more effective, better tolerated, and safer than both TCAs. Fewer side effects mean better compliance and overall treatment success.  

    • Fewer side effects: SNRIs are associated with fewer anticholinergic side effects than older antidepressants. Anticholinergic effects can include dry mouth, blurred vision, constipation, urinary retention, and confusion. The reduced incidence of these effects with SNRIs makes them a more tolerable option for many patients, especially the elderly or those with certain pre-existing conditions. 

    • Fewer drug interactions: SNRIs have fewer drug interactions, making them easier to integrate into treatment plans that include other medications. 

    • Weight and metabolic effects: Unlike some other antidepressants that can lead to significant weight gain or metabolic changes, SNRIs are generally considered to have a neutral or less pronounced impact on weight and metabolism. This is crucial for long-term treatment, as weight gain can be a deterrent for some patients.  

    • Sexual side effects: While sexual dysfunction can still occur with SNRIs, the degree and frequency are often less compared to other antidepressants. Managing sexual side effects is important for maintaining quality of life and treatment adherence. 

    • Sedation and sleep disturbance: SNRIs tend to cause less sedation than TCAs, which can benefit patients who need to maintain alertness during the day. However, they can sometimes lead to sleep disturbances. 

    • Cardiovascular effects: SNRIs do not have the same level of cardiovascular effects (like heart rhythm changes) seen with some older antidepressants, making them a safer choice for patients with heart conditions.

  • SSRIs vs. SNRIs

    Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are both classes of medications commonly used to treat mental health conditions, primarily depression and anxiety disorders. Despite their similarities in treating these conditions, they function differently and have profiles that differentiate them.  




    Conditions treated 

    Both SSRIs and SNRIs are primarily used to treat major depressive disorder and anxiety disorders. They are often first-line treatments for these conditions. 

    SSRIs are most effective for treating depression and a variety of anxiety disorders. While also used for depression and anxiety, SNRIs can be particularly effective in treating chronic pain conditions, such as neuropathic pain and fibromyalgia, due to their impact on norepinephrine.  

    How they work 

    Both classes of drugs work by altering the balance of neurotransmitters in the brain, which are chemicals that transmit signals between nerve cells. They both achieve this by inhibiting certain neurotransmitters' reuptake (reabsorption) into brain cells. 

    SSRIs primarily increase the level of serotonin in the brain by inhibiting its reuptake. In addition to affecting serotonin, SNRIs also increase levels of norepinephrine, another neurotransmitter that influences mood and pain perception. 

    Side effects 

    Both can have side effects, although these can vary in type and intensity. Common side effects include nausea, dizziness, and sleep disturbances. 

    Typically, SSRIs have fewer side effects compared to older antidepressants, but they can still cause sexual dysfunction and weight gain. SNRIs may cause similar side effects as SSRIs but can also lead to increased blood pressure due to their effect on norepinephrine.  

    Withdrawal symptoms 

    Discontinuing either SSRIs or SNRIs abruptly can lead to withdrawal symptoms, so it’s important to taper off these medications under medical supervision.  

    Withdrawal symptoms may last longer when abruptly discontinuing SSRIs, than when abruptly discontinuing SNRIs.(14)

    Onset of action 

    Both SSRIs and SNRIs may take several weeks to show full efficacy 

    SNRIs sometimes offer quicker relief for symptoms like chronic pain. 

How do SNRIs make you feel? Side effects and more

The effects of SNRIs can vary from person to person. Generally, these medications improve mood and cognitive function, such as focus and memory. They can also alleviate physical symptoms of depression, like headaches or pain. When taken for chronic pain, SNRIs can gradually reduce the intensity of pain experienced.

As SNRIs begin to alleviate symptoms of depression or anxiety, you may notice a decrease in symptoms and positive changes in associated emotions, such as increased happiness and a sense of calmness. People who take SNRIs may also experience heightened engagement and motivation.  Serotonin-norepinephrine reuptake inhibitors (SNRIs) can cause a range of side effects, classified as mild, serious, or severe. Distinguishing between these categories is crucial for appropriate management.  

Common side effects

These side effects are often temporary and may get better over time. If mild, they may not require intervention.  

Serious side effects

  • Anxiety 

  • Tremors 

  • Increased heart rate 

Allergic reactions are typically acute and can escalate quickly. Look out for signs like skin rashes or hives, swelling of the face, lips, or tongue, breathing difficulties, nausea and vomiting, sudden drop in blood pressure, dizziness, fever, or loss of consciousness. 

If you experience any severe side effects, seek medical attention immediately. 

SNRI precautions and interactions

  • Can you take SNRI drugs while pregnant?

    If you are pregnant, be careful using SNRIs. Some SNRIs may be associated with certain pregnancy risks, and alternative treatment options may need to be explored. Your doctor will help you weigh potential benefits against potential risks to the developing fetus. 

  • Not recommended for children and adolescents

    SNRIs are generally not the first line of treatment for pediatric patients. The safety and efficacy of SNRIs in children and adolescents can vary, and doctors carefully assess the individual's medical history, symptoms, and overall well-being before considering SNRI treatment. 

  • Use in elderly populations

    SNRIs can be prescribed for older adults, but dosages may need to be adjusted based on factors such as renal function and other health considerations. Older patients may be more prone to specific side effects. 

  • Alcohol and SNRIs

    Combining alcohol with SNRIs can amplify the sedative effects of both substances and increase the risk of drowsiness, dizziness, and impaired coordination. It is advisable to limit alcohol intake and inform your doctor about your alcohol consumption when prescribed SNRIs. 

  • Risks of SNRI discontinuation

    Discontinuing SNRIs, whether due to treatment completion or a change in medication, carries its own set of precautions. Abruptly stopping SNRIs can lead to discontinuation syndrome, characterized by symptoms such as dizziness, nausea, irritability, and sensory disturbances. To mitigate risks, work with your doctor to gradually taper off the drug if you want to stop. 

  • Can SNRIs be abused?

    While SNRIs are not typically associated with abuse in the same manner as some other medications, they are still prescription drugs that should be used as directed. As with any drug, misusing SNRIs by taking higher doses than prescribed or using them without a legitimate medical need can lead to serious side effects and complications.

  • Rhodiola and SNRI drugs

    Rhodiola is an herbal supplement, and its interaction with SNRIs has yet to be extensively studied. However, herbal supplements can have effects on neurotransmitter systems. Discuss using Rhodiola with your doctor when taking SNRIs to assess potential interactions and any impact on your overall treatment plan to ensure safety.

  • Overdose information

    Overdosing on SNRIs can have severe consequences and require prompt medical attention. Recognizing the signs and symptoms of an overdose is crucial: 

    • Serotonin syndrome: Excessive serotonin levels can lead to serotonin syndrome. Symptoms include agitation, confusion, rapid heart rate, dilated pupils, muscle rigidity, and, in severe cases, seizures. 

    • Gastrointestinal distress: Overdosing may cause nausea, vomiting, and diarrhea. Persistent gastrointestinal symptoms can indicate a potential overdose. 

    • Cardiovascular effects: Increased heart rate, elevated blood pressure, and irregular heart rhythms are potential cardiovascular effects of an overdose. 

    • Neurological symptoms: Overdosing may result in dizziness, tremors, and, in extreme cases, loss of consciousness. Neurological symptoms should be taken seriously. 

    In the case of a suspected overdose, seek immediate medical attention. Do not hesitate to contact emergency services or a poison control center. Overdosing on SNRIs requires urgent intervention to mitigate potential complications.


  • Can you take SSRIs and SNRIs together?

    Combining SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) is generally not recommended due to the risk of serotonin syndrome—a potentially serious condition. However, your doctor may sometimes carefully manage a transition between the two classes.

  • Can SNRIs cause mania?

    While uncommon, SNRIs have been associated with an increased risk of inducing manic or hypomanic episodes in patients with bipolar disorder. It's essential to discuss any history of bipolar disorder or manic symptoms with your healthcare provider before starting an SNRI. 

  • Can my SNRI medication make my anxiety worse?

    In some cases, SNRIs may initially increase anxiety before providing relief. This potential side effect should be communicated to your healthcare provider. Adjustments to dosage or medication may be considered to address such issues.

  • Do SNRIs cause dementia?

    There is no conclusive evidence linking SNRIs to dementia. However, discuss any cognitive concerns with your doctor. They can evaluate your situation and consider alternative medications or adjustments if needed.

  • Will an SNRI cause erectile dysfunction?

    Erectile dysfunction is a potential side effect of SNRIs. If you experience sexual side effects, discuss them with your healthcare provider. They may be able to adjust your dosage or recommend alternative medications that may have a lesser impact on sexual function. 

  • What is the most prescribed SNRI?

    Duloxetine (Cymbalta) is one of the most commonly prescribed SNRIs. It is used to treat conditions such as major depressive disorder, generalized anxiety disorder, and certain types of chronic pain.

  • How do I know if an SNRI dose is too high?

    Signs of an excessively high SNRI dose may include increased side effects, worsening of existing symptoms, or the emergence of new, concerning symptoms. Talk to your doctor or pharmacist immediately if you notice any concerning symptoms.  

  • What’s the difference between tricyclic antidepressants and SNRIs?

    Tricyclic antidepressants (TCAs) and SNRIs are different classes of antidepressants. While both impact neurotransmitter levels, TCAs primarily affect norepinephrine and serotonin, whereas SNRIs specifically target serotonin and norepinephrine reuptake.

  • What is the SNRI with the least side effects?

    The response to SNRIs varies; no SNRI is universally associated with the least side effects. Duloxetine (Cymbalta) and venlafaxine (Effexor) are commonly prescribed SNRIs, but the choice depends on individual factors and medical history. Discussing potential side effects with your healthcare provider can help tailor the choice of medication to your specific needs. 

How to get SNRIs online

Step 1

Book an appointment to discuss SNRI medications.

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Step 2

Talk to your doctor online about your mental health condition or pain symptoms.

Visit with a doctor on your smartphone or computer.

Step 3: pick up at local pharmacy

Step 3

Pick up your SNRI medication, if prescribed.

Prescriptions are provided at the doctor’s discretion. We can send prescriptions to any local pharmacy. 

SNRI pricing details

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  • Cancel anytime

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PlushCare is dedicated to providing you with accurate and trustworthy health information.

  1. Harvard Health Publishing. "Serotonin: The natural mood booster" Accessed on December 20, 2023 at 

  2. PharmWiki. Accessed on December 20, 2023 at 

  3. National Center for Biotechnology Information. “Depression: How effective are antidepressants?” Accessed on December 20, 2023 at 

  4. MIT Medical. Accessed on December 20, 2023 at 

  5. National Center for Biotechnology Information. “Selective Serotonin Reuptake Inhibitors”  Accessed on December 20, 2023 at 

  6. Michigan Medicine. “Anxiety Educational Resources” Accessed on December 20, 2023 at 

  7. JAMA Psychiatry. “Individual Differences in Response to Antidepressants” Accessed on December 20, 2023 at 

  8. Journal of Clinical Sleep Medicine. “Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment” Accessed on December 20, 2023 at 

  9. PubMed. Accessed on December 20, 2023 at 

  10. PubMed. Accessed on December 20, 2023 at 

  11. National Center for Biotechnology Information. Accessed on December 20, 2023 at 

  12. The American Journal of Psychiatry. “A Model of Placebo Response in Antidepressant Clinical Trials” Accessed on December 20, 2023 at 

  13. National Center for Biotechnology Information. Accessed on December 20, 2023 at 

  14. PubMed: "Neurobiology of Depression: An Integrated View of Key Findings." Accessed on January 30, 2024, at

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