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SSRIs and SNRIs

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: September 2023

Postpartum depression (PPD) is a common mental health condition that affects many women after childbirth. Fortunately, there are effective drug treatments available. Several types of antidepressant drugs are commonly prescribed to treat PPD. Antidepressants are used to treat depression and other mental health disorders.1

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have shown promise in treating postpartum depression. They are usually the first-line drugs prescribed for PPD.1

How do SSRIs and SNRIs work?

SSRIs and SNRIs are 2 classes of antidepressants. These drugs work by balancing chemical messengers (neurotransmitters) in the brain. This helps to stabilize mood, reduce anxiety, and restore a sense of well-being.2,3

SSRIs increase serotonin in the brain. Serotonin is a neurotransmitter that regulates mood, emotions, and feelings of well-being. SSRIs help maintain higher levels of serotonin, which can lessen symptoms of depression.2

SNRIs, on the other hand, increase both serotonin and norepinephrine. Norepinephrine is a neurotransmitter that plays a role in regulating energy levels and alertness. By increasing both of these neurotransmitters, SNRIs offer a broader approach to managing depression and its symptoms.3

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How is it beneficial for postpartum depression?

Both SSRIs and SNRIs can reduce feelings of sadness, hopelessness, and anxiety, helping new parents enjoy their time with their newborns. Also, PPD can lead to troubling thoughts or obsessions about the baby's well-being. These medicines can help reduce these intrusive thoughts.2,3

Examples of SSRIs and SNRIs

The US Food and Drug Administration (FDA) has approved the following SSRIs to treat depression:2

  • Citalopram (Celexa®)
  • Escitalopram (Lexapro®)
  • Fluoxetine (Prozac®)
  • Paroxetine (Paxil®, Pexeva®)
  • Sertraline (Zoloft®)

SNRIs that are FDA-approved to treat depression include:3

  • Desvenlafaxine (Khedezla®, Pristiq®)
  • Duloxetine (Cymbalta®, Drizalma®, Irenka®)
  • Levomilnacipran (Fetzima®)
  • Milnacipran (Savella®)
  • Venlafaxine (Effexor®)

What are the possible side effects?

While SSRIs and SNRIs are generally safe and effective, they can cause some side effects. Side effects can vary depending on the specific drug you are taking. Common side effects include:2,3

  • Nausea and vomiting
  • Fatigue or sleepiness
  • Dry mouth
  • Dizziness
  • Insomnia
  • Sexual problems, like reduced sex drive (libido) or trouble achieving orgasm
  • Weight changes

SSRIs and SNRIs have a boxed warning, the strictest warning from the FDA. They have this warning because kids, teenagers, and young adults may have an increased risk of suicidal thoughts or behaviors when taking SSRIs. This risk may be highest in the first few weeks of treatment or right after changing drug dosages.2,3

These are not all the possible side effects of SSRIs and SNRIs. Talk to your doctor about what to expect when taking an SSRI or SNRI. You also should call your doctor if you have any changes that concern you when taking SSRIs or SNRIs.

Other things to know

If you think you have PPD or are struggling with your mental health after giving birth, reach out to your doctor. They can assess your condition, provide guidance, and discuss treatment options. Treatment may include an SSRI or SNRI along with talk therapy or support groups.

Before taking an SSRI, tell your doctor if you are pregnant or planning to become pregnant. Some antidepressants may harm an unborn baby.2,3

Do not stop taking an SSRI or change dosage amount without first talking to your doctor. Stopping some SSRI drugs suddenly can lead to withdrawal symptoms. These may include nausea, dizziness, sleepiness, and feeling like you have the flu.2,3

Your doctor will monitor you closely for any mental health side effects when you start or change doses of an antidepressant. If you have thoughts of harming yourself or others, call or text the Suicide & Crisis Lifeline at 988 to reach a crisis counselor.2,3

Before beginning treatment for postpartum depression, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

While they may come with some side effects, the potential benefits of these medicines far outweigh the risks for many people. Work with your doctor to find the most appropriate treatment plan for you.