In a clinical study to determine the safety of bupropion use during pregnancy , the results suggested that it does not increase the risks for birth defects or spontaneous abortions. Because the results of this study have not been confirmed by other studies, it is recommended bupropion be used during pregnancy only if the potential benefit of treatment justifies the potential risk to the fetus. Bupropion has been found in human milk. Because of the potential for serious adverse effects in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug based on the importance of continuing the drug to the mother.
There have been no adequate and well-controlled studies on the use of Strattera in pregnant women and it should not be used unless the potential benefit justifies the potential risk to the fetus. Strattera was found to be excreted in milk in animal studies. It is unknown if it is excreted in human milk. Caution should be exercised if Strattera is given to a nursing woman. There have been no adequate and well-controlled studies on the use of Nucynta in pregnant women and it should not be used unless the potential benefit justifies the potential risk to the fetus.
All bupropion dosage forms and Strattera carry a boxed warning regarding a risk of increased suicidal thinking and behavior in some younger patients. Patients of all ages who are started on either drug should be monitored for signs of suicidal thoughts and behaviors. You should not take any NRI medicine if you are allergic to any of the active or inactive ingredients. The presence of other medical problems and conditions may affect the use of NRIs. You should not use bupropion medicines if you have any of the following conditions:.
You should not use Strattera if you have any of the following conditions:. You should not use Nucynta if you have any of the following conditions:. The sudden discontinuation of any antidepressant , such as bupropion , may cause withdrawal-like symptoms. This is sometimes called discontinuation syndrome and may include the following symptoms:.
A gradual reduction in the dose rather than abruptly stopping is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered.
Your healthcare provider may continue decreasing the dose but at a more gradual rate. Nucynta can cause physical dependence. The following withdrawal symptoms may occur:. To help lessen withdrawal symptoms, do not change the dose of Nucynta unless your healthcare professional advises you. The development of a potentially life-threatening serotonin syndrome may occur with concomitant use of NRIs and serotonergic drugs that increase the levels of serotonin such as SNRIs e. Symptoms of serotonin syndrome may include high fever, seizures, uneven heartbeat, or passing out.
Emergency medical care may be needed if any of these symptoms occur. Strattera and bupropion drugs are not controlled substances. Nucynta is a Schedule II controlled substance and has an abuse potential similar to other opioid pain relievers. All patients treated with opioids require careful monitoring for signs of abuse and addiction because the use of opioid pain relievers carry the risk of addiction even under appropriate medical use.
Ask your doctor and pharmacist about the most common possible side effects for your specific SNRI and read the patient medication guide that comes with the prescription. SNRIs are safe for most people.
However, in some circumstances they can cause problems. For example:. Other issues to discuss with your doctor before you take an SNRI include:. Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.
Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood. SNRIs are not considered addictive. However, stopping antidepressant treatment abruptly or missing several doses may cause withdrawal-like symptoms.
This is sometimes called discontinuation syndrome. Withdrawal-like symptoms may be more likely to occur with venlafaxine or desvenlafaxine, though they can occur when any SNRI is stopped abruptly. Work with your doctor to gradually and safely decrease your dose. People may react differently to the same antidepressant. For example, a particular drug may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does.
Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of special blood tests may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication. When choosing an antidepressant, your doctor takes into account your symptoms, any health problems, other medications you take and what has worked for you in the past.
Typically, it may take several weeks or longer before an antidepressant is fully effective and for initial side effects to ease up. Your doctor may recommend dose adjustments or different antidepressants, but with patience, you and your doctor can find a medication that works well for you. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
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This content does not have an Arabic version. See more conditions. Serotonin and norepinephrine reuptake inhibitors SNRIs. Products and services. Serotonin and norepinephrine reuptake inhibitors SNRIs Antidepressant SNRIs help relieve depression symptoms, such as irritability and sadness, but some are also used for anxiety disorders and nerve pain. By Mayo Clinic Staff.
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