What is the likely benefit of a snri compared to a ssri

Hello, I've had to reduce my dose of citalopram from 40mg to 30mg, as anxiety went through roof. Feeling down a a result. Went onto citalopram as seroxat stopped working. Pysc has suggested venlafaxine or mirtazapine. I'm thinking of venlafaxine, due to possible weight gain with mirtazapine. Is a snri recommendation based on neephra whatever, reuptake being stopped, that may work for me? Sort of pot luck chance it might be better for me? I know lots of people don't get on with venlafaxine, but presume some people do. Feel like I have to take the chance, as I don't want to stay as i am. Having a dual action might be better? I understand that if ssris don't do much for you, then there's a higher chance a snri will, as apposed for someone taking their first anti depressant. I have had recurring depression for over 20 years. Trying to see if it's worth taking the chance with venlafaxine. Thanks.

Hello,

I am not familiar with mirtazapine, but I, and I know a number of other individuals also experience fairly significant weight gain with Venlafaxine.  Also, fatigue.  I am not sure about mirtzapine, but be aware that Venlafaxine is extremely difficult to discontinue if you decide that you do not like it.  It worked for me for a while.  Good luck with your decision, I know it is not easy.  

Hi Nigel. I have changed from citalopram after 8 years as no longer effective. To sertraline awful side effects! Am now taking venlaflaxine but only been on it a week. An on 37.5mg at the moment. Its totally decreased my appetite! Only annoying side effect so far is sleep deprivation but not sure if this is due to anxiety as only on a small dose. X

hi nigel it is very often a different experience for each person when they take a certain med.  one person may gain weight, the other loses it (i always lose my appetite for a few weeks whenever i take any ssri or srni)..

some people get tired on a med which others say gives them energy, and so on.

so often you just need to try for yourself to see if a med suits you.

regarding the dual action of venlafaxine (snri), this is only really seen at higher doses.  at doses of 75mg or 150mg it is documented that venlafaxine acts as an ssri instead.   it also states on the internet that venlafaxaine has a 30-fold higher selectivity for serotonin reuptake inhibition compared with norepinephrine reuptake inhibition.

the snri med called duloxetine is nore of an actual snri, as that has a 10-fold higher selectivity for serotonin reuptake inhibition compared with norepinephrine reuptake inhibition