Which class of medications may exacerbate anxiety in some clients?

SNRIs, or serotonin-norepinephrine reuptake inhibitors, are primarily used to treat depression and anxiety disorders, but in some clients, particularly at the beginning of treatment or when dosages are adjusted, they may lead to increased anxiety symptoms. This potential exacerbation can occur due to the initial increase in norepinephrine, which may cause heightened arousal and anxiety.

Understanding the mechanism of SNRIs helps clarify this outcome; they elevate levels of both serotonin and norepinephrine, neurotransmitters associated with mood regulation. However, while serotonin can have an anxiolytic effect, increased norepinephrine may counteract these benefits for certain individuals, leading to heightened anxiety.

In comparison, SSRIs (selective serotonin reuptake inhibitors) are more commonly known to alleviate anxiety and generally have a lower incidence of exacerbation of anxiety symptoms. NDRIs (norepinephrine-dopamine reuptake inhibitors) and TCAs (tricyclic antidepressants) are also used in the treatment of depression, but their profiles are less associated with the acute increase in anxiety, particularly because they do not typically elevate norepinephrine to the same degree as SNRIs in their initial effect. Hence, SNRIs are recognized