SSRIs and SNRIs are antidepressant prescription drugs that are used to treat depression and anxiety symptoms.
SSRIs are Selective Serotonin Reuptake Inhibitors and help to lift depression and decrease anxiety by increasing the amount of serotonin available in the brain. Whereas, SNRIs are Selective Norepinephrine Reuptake Inhibitors, which work to relieve depression and anxiety by balancing both serotonin and norepinephrine in the brain.
These two classes of antidepressants work differently to mitigate symptoms, but both can be very effective. That being said, the process of finding the right medication for you, and the right dosage, requires some time and a lot of patience, as it can be a bit of a trial-and-error process.
While one antidepressant might work wonders for one person, that very same antidepressant might do little to help someone else. However, provided there aren’t any adverse reactions, it’s often best to wait a few weeks before an antidepressant is deemed ineffective.
Furthermore, sometimes the issue isn’t the antidepressant itself, but rather the dosage of the antidepressant.
Let’s start by taking a look at the average recommended starting dose of each medication, specifically for the treatment of depression
SSRIs ( Selective Serotonin Reuptake Inhibitors)
SNRIs ( Selective Norepinephrine Reuptake Inhibitors)
Each of these SSRI and SNRI recommended starting doses, can be adjusted depending on each person’s varying degrees of sensitivity to the medication. For example, some may tolerate starting out at the recommended 20mg starting dose of citalopram, while others might find this to be too much, leading to side effects such as increased anxiety, brain fog, and fatigue.
In these cases, it may be beneficial to lower the starting dose to 5mg or 10 mg and increase the medicine slowly as the body adjusts. Lower starting doses are also recommended for elderly patients and patients with panic disorder, significant anxiety, or hepatic disease.
When it comes to using these medications to help treat the symptoms of anxiety disorders, it is sometimes recommended to start at even lower doses than those used in treating depression. This is due to the temporary side effect of increased anxiety during the adjustment period while the amount of serotonin available in the brain increases and balances out.
An increase in anxiety is a very common start-up response to SSRIs and SNRIs, and it will usually settle down within one to two weeks. However, if this side effect is particularly troublesome, your doctor could temporarily add an additional medication to relieve some of this anxiety during the start-up period.
The guidelines for the starting doses for all of these SSRIs and SNRIs are not set in stone. In fact, some studies find lower doses to be more effective in treating depression, while other studies find that the exact opposite can be true.
In our next article, we will look further into the impact that the dosage of a medication can have on the side effects experienced as well as the efficacy of the medication at these dosages.