Antidepressants - SSRIs and SNRIs: Nursing Pharmacology

00:00 / 00:00



fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), paroxetine (Paxil, Pexeva), citalopram (Celexa), escitalopram (Lexapro)
duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), levomilnacipran (Fetzima)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Inhibit serotonin reuptake, increasing its concentration in the synaptic cleft
Inhibit serotonin and norepinephrine reuptake, increasing their concentration in the synaptic cleft
  • Major depressive disorder
  • Anxiety disorders (obsessive-compulsive disorder, posttraumatic stress disorder, panic disorder, phobias)
  • Phobias
  • Major depressive disorder
  • Generalized anxiety disorder
  • Neuropathic pain
  • Anxiety
  • Nervousness
  • Agitation
  • Dizziness
  • Drowsiness
  • Insomnia
  • Loss of appetite
  • Nausea
  • Vomiting
  • Diarrhea
  • Sexual dysfunction
  • Headache
  • Sweating
  • Hyponatremia
  • Dry mouth
  • Bruxism
  • Serotonin syndrome
  • Boxed warning: suicidal thinking in children, adolescents, and young adults
  • SNRIs: hypertension, tachycardia, closed-angle glaucoma, urinary retention
  • Combination with MAOIs
  • QT prolongation or myocardial infarction
  • Pregnancy
  • Renal or hepatic disease
  • Diabetes
  • Glaucoma
  • Severely depressed clients with suicidal thinking
Assessment and monitoring: SSRIs and SNRIs
  • Baseline assessment of depressive symptoms; continue during antidepressant therapy
  • Monitor for suicidal thoughts, especially during the first few weeks
  • Baseline mental status, vital signs, weight, serum electrolytes, kidney and liver function
  • Pregnancy status

Client education: SSRIs and SNRIs
  • Therapeutic effects can take 1–3 weeks
  • Take medication exactly as prescribed
  • Report any changes in symptoms or suicidal thoughts to health care provider
  • Administer medication in the morning
  • Avoid hazardous activities with fatigue and dizziness
  • Notify healthcare provider about adverse effects
    • SNRIs: Void before taking this medication
  • Never abruptly stop medication therapy


Antidepressants are medications primarily used to treat major depressive disorder, which is a condition associated with a persistent feeling of sadness and loss of interest in everyday activities.

Even though the exact cause of major depressive disorder is still unknown, there's some evidence that suggests that it’s related to low levels of neurotransmitters called monoamines, which include serotonin, norepinephrine, and dopamine.

In this video, we’re going to cover two of the main classes of antidepressants: selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.

First, let’s focus on selective serotonin reuptake inhibitors, or SSRIs for short, such as fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram, and escitalopram.

SSRIs are taken orally, and once absorbed into the bloodstream, they travel to the brain. Here, SSRIs inhibit the reuptake of serotonin.

As a result, free levels of serotonin within the synaptic cleft are increased right away, although the effect of SSRIs alleviating symptoms of depression are not evident for a few weeks.

Other indications for SSRIs include anxiety disorders like obsessive-compulsive disorder, or OCD; post traumatic stress disorder, or PTSD; panic disorder and phobias; as well as eating disorders like bulimia.


  1. "Focus on Nursing Pharmacology" LWW (2019)
  2. "Pharmacology" Elsevier Health Sciences (2014)
  3. "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
  4. "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
  5. "SSRI Antidepressant Medications" The Primary Care Companion to The Journal of Clinical Psychiatry (2001)

Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.