Safety issues with SNRIs

SNRIs are safe for most people. But sometimes they can slightly raise blood pressure, lower electrolyte levels such as sodium and worsen liver conditions. SNRIs sometimes can affect acute angle-closure glaucoma, a form of glaucoma that happens when the iris bulges and raises pressure inside the eye. Most of these safety issues can be monitored by your healthcare professional while you're taking the medicine.

Talk with your healthcare professional about safety issues before you take an SNRI, including:

• Medicine interactions. Tell your healthcare professional about any other prescription or nonprescription medicines, herbs or other supplements you're taking. Some antidepressants can cause dangerous reactions when taken with certain medicines or herbal products.

  For example, SNRIs may slightly raise your risk of bleeding, especially when you're taking other medicines that also raise the risk of bleeding. These other medicines can include ibuprofen (Advil, Motrin IB, others), aspirin, warfarin (Jantoven) and other blood thinners.

• Serotonin syndrome. Rarely, antidepressants can cause dangerously high levels of serotonin in the body. This is called serotonin syndrome. It happens most often when you take two medicines that both raise serotonin levels. This includes taking an SNRI with other antidepressants, certain pain or headache medicines, or the herbal supplement St. John's wort.

  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. Get medical help right away if you have any of these symptoms.

• Antidepressants and pregnancy. Some antidepressants may harm your baby if you take them during pregnancy or while you're breastfeeding. If you are pregnant, are thinking about getting pregnant or are breastfeeding, talk to your healthcare professional about the benefits and possible risks of antidepressants. Don't stop taking your medicine without talking with your healthcare professional first.