why are serotonin–norepinephrine reuptake inhibitors used for anxiety when norepinephrine causes anxiety?
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The activity of SNRI’s influence the ability of serotonin and norepinephrine, when acting as neurotransmitters in the nervous system, to deliver the neuroelectochemical signal across the synaptic cleft between neurons. They do not influence the activity of norepinephrine acting as a hormone in the body, where it is alternatively called adrenaline. Serotonin, norepinephrine, and dopamine are in family of neurotransmitters with a common parent molecule and all three are vital neurotransmitters in the areas of the brain responsible for emotional experience. Different qualities of emotional experience seem to relate to the functioning of the neuron clusters using those various neurotransmitters. Dopamine activity is associated with pleasure and joy, serotonin with serenity and wellbeing, and norepinephrine more subtly with the somatic qualities of emotion. The SSRI and SNRI medicines and the one DNRI medicine slow down how quickly neurons “clean” the synapse after neurotransmitters are released, as the next signal needs a clean synapse to work properly. Giving the neurotransmitters an extra moment to deliver their signal increases the chance that the signal is propagated from one neuron to the next across the synapse, which is the crux activity of the brain itself. Successful synaptic signaling influences the support cells in the brain to reinforce, or up-regulate, that activity and strengthen the neurons involved, allowing them to work more effectively. Depression and anxiety are due to pathologically under-active neurons, so medicines that promote or increase activity will stimulate growth and regeneration of those neurons given time. All three types of medicines can cause a side-effect of anxiety but most people can take them without that happening.
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