We live in times where terms like "antidepressants" and "mental health disorders" are used quite frequently. Many of us go for therapy while some feel life is manageable without it, and some, need to be on prescribed medication to get through each day. Of course, not everyone who goes for therapy necessarily has to have a disorder, and having a disorder does not mean being dysfunctional either.
For the ones who are on prescribed medication, the medicines can be categorised under - SSRIs & SNRIs
So, what do these two terms mean? Is one better than the other? To answer these questions and break it down further we speak to Dr Umang Kochhar, a consultant psychiatrist based in Delhi.
(It's important to note that any medication should only be taken in consultation with your psychiatrist who is best placed to judge with what works for your condition.)
What are SSRIs?
SSRIs or Selective serotonin reuptake inhibitors are a class of antidepressants that have the same mechanism of action in common – it selectively and potently inhibits the serotonin transporter (SERT), thereby preventing the reuptake of serotonin. This increases the availability of serotonin, which is one of the neurotransmitters or chemicals in the brain which elevates our mood. It is due to the deficiency of serotonin and other similar chemicals in the brain that we feel depressed.
According to an estimate, SSRI prescriptions in US alone occur at the rate of 6 prescriptions per second, 24/7, 365 days a year.
How are SNRIs different from SSRIs?
Another important neurotransmitter or chemical in the brain that is responsible for mood is norepinephrine. SNRIs or Serotonin Norepinephrine reuptake inhibitors prevent reuptake of both serotonin as well as norepinephrine through similar inhibition of both SERT as well as NET (norepinephrine transporter).
Which of the two are better for consumption?
While SNRIs can be more effective than SSRIs, some people still find that SSRIs are more effective for them. SNRIs, having a dual action, over both serotonin and norepinephrine, would be more effective in improving the depressive symptoms. There is a current debate and research going on if this is so. Apart from depression, SNRIs are also helpful in the treatment of multiple pain syndromes and in treatment of some peri-menopausal symptoms.
What are the indications for taking SSRIs and SNRIs?
Both SSRIs and SNRIs are given to treat conditions like depression, anxiety disorders like OCD, panic disorder, social anxiety disorder, PTSD, generalised anxiety disorder, in eating disorders, in premenstrual dysphoric disorder, for premature ejaculation, autism etc.
What are the side effects of SSRIs and SNRIs?
The side effects of both SSRIs and SNRIs are pretty much the same. These include sexual dysfunctions like a decrease in libido, delayed orgasms, gastrointestinal issues like nausea, diarrhoea, flatulence, anorexia etc. Other side effects also include certain cardiovascular problems, headaches, impacting sleep, emotional blunting, etc.