Confused about SNRIs in anxiety/panic disorder

[deleted500612]

Hey guys, can anyone explain to me the general logic/mechanism behind SNRIs like Venlafaxine commonly being used to treat anxiety and panic disorders? To me it seems completely counterintuitive given that the major pathophysiology behind anxiety disorders is an increase in norepinephrine and depression of serotonin. Using a drug to treat anxiety that is going to further increase norepinephrine (with one of the common listed side effects of SNRIs even being that they can actually cause anxiety) just seems illogical and confusing to me. Is it simply that the increase in serotonin from SNRIs provides enough benefit to overshadow the further elevation of norepinephrine? If this is the case then wouldn't SSRIs just be flat out better in all circumstances because they avoid elevating norepinephrine altogether?

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[pd1112]

If you figure out the exact answer to this, you'll be celebrated by neuroscientists worldwide lol It's just like a lot things in neuroscience/neuropsychiatry; the exact pathophys of anxiety & depression isn't understood that well, so the drug effects aren't either. Remember that anxiety is also one of the MC s/e of SSRIs too.

 

[deleted500612]

If you figure out the exact answer to this, you'll be celebrated by neuroscientists worldwide lol It's just like a lot things in neuroscience/neuropsychiatry; the exact pathophys of anxiety & depression isn't understood that well, so the drug effects aren't either. Remember that anxiety is also one of the MC s/e of SSRIs too.

I hate psych so much, having to memorize stuff like this that has no logical explanation behind it is a nightmare to me, I have to really understand something in order to retain it properly. Not to mention the definition of most psychiatric disorders being arbitrarily changed every few years anyways...