Safety issues

SNRIs are safe for most people. However, in some circumstances they can cause problems. For example:

• Venlafaxine, desvenlafaxine and levomilnacipran may raise your blood pressure.
• Duloxetine may worsen liver problems.

Other issues to discuss with your doctor before you take an SNRI include:

• Drug interactions. Tell your doctor about any other prescription or over-the-counter medications, herbs or other supplements you're taking. Some antidepressants can cause dangerous reactions when combined with certain medications or herbal products. For example, SNRIs may increase your risk of bleeding, especially when you're taking other medications that also increase the risk of bleeding, such as ibuprofen (Advil, Motrin IB, others), aspirin, warfarin (Coumadin, Jantoven) and other blood thinners.
• Serotonin syndrome. Rarely, serotonin syndrome can occur when you take antidepressants that can cause levels of serotonin to increase in your body. This most often occurs when two medications that raise serotonin are combined, such as other antidepressants, certain pain or headache medications, or St. John's wort.
  • Signs and symptoms of serotonin syndrome include anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and rapid heart rate.
  • Seek immediate medical attention if you have any of these symptoms.
• Antidepressants and pregnancy. Talk with your doctor about the risks and benefits of specific antidepressants. Some antidepressants may harm your baby if you take them during pregnancy or while you're breast-feeding. If you're taking an antidepressant and considering getting pregnant, talk to your doctor about the possible risks. Don't stop taking your medication without contacting your doctor first, as stopping might pose risks for you.