Psychiatrist Explains All SNRIs

What's the difference between the four SNRIs, and how do you decide which one to prescribe? Venlafaxine (Effexor), desvenlafaxine (Pristiq), duloxetine (Cymbalta), and levomilnacipran (Fetzima) all belong to the same antidepressant class, but they aren't interchangeable when it comes to clinical decision-making. For psychiatric mental health nurse practitioners (PMHNPs) and other psychiatric prescribers, understanding the differences between these medications can help guide more confident, individualized treatment decisions. In this video, Dr. Richardson, psychiatrist, walks through all four SNRIs (serotonin-norepinephrine reuptake inhibitors), breaking down the clinical differences that matter most when prescribing these medications. Chapters 00:00 Intro 00:44 Overview of the SNRI Class 01:33 Venlafaxine's mechanism changes with dose 03:00 When to select an SNRI over an SSRI 06:33 SNRI side effects 14:42 SNRI CYP clearance 17:16 SNRIs in pregnancy and breastfeeding 19:34 FDA indications for SNRIs 22:28 Venlafaxine 26:12 Desvenlafaxine 29:45 Duloxetine 34:14 Levomilnacipran 38:03 Comparing SNRIs & Wrap Up WORK THROUGH CASES WITH ME 🧠 Want to go deeper with live, case-based learning? Join the Confident Psychiatry community for PMHNPs: https://confidentpsych.com ⸻ Disclaimer: All content is for educational and informational purposes only and is not medical advice, diagnosis, or treatment guidance. It does not replace independent clinical judgment, training, supervision, consultation, or review of current prescribing information and professional guidelines. Content reflects the educational approach of Dr. Gerald Richardson, a board-certified psychiatrist, and may contain errors or become outdated as guidelines, medications, and psychiatric practice evolve. No clinician-patient relationship is created through this content. #pmhnp #psychiatry #psychopharmacology #antidepressant