What is the role of SNRIs in anxiety disorders?

• A. Being only effective for panic disorder; they cause no withdrawal.
• B. Being effective for GAD and social anxiety; monitor BP with venlafaxine and watch for withdrawal symptoms.
• C. Worsening anxiety in most patients.
• D. Replacing CBT as first-line treatment.

Answer: (B)

SNRIs help anxiety by increasing both serotonin and norepinephrine in brain circuits that regulate worry and arousal. This boost can reduce the pervasive anxious thoughts seen in generalized anxiety disorder and the excessive fear and avoidance in social anxiety disorder, making these medications effective options for those conditions. With venlafaxine, a higher dose can raise blood pressure, so regular blood pressure monitoring is important. They can also cause withdrawal symptoms if the medication is stopped abruptly, so gradual tapering is advised when discontinuing. Taken together, this reflects their role as effective pharmacologic options for certain anxiety disorders, used with attention to BP and withdrawal risks, rather than being limited to panic disorder or replacing psychotherapy as a first-line approach.