Medication for the Treatment of Anxiety & Depression

Anxiety and depression are among the most common disorders in psychiatry. When anxiety and depression coexist, the first goal is often treating the depression first, with the expectation that anxiety will slowly diminish. Often more than one medication is used when both conditions are present.

Anxiety

• Anxiety is a normal reaction to everyday stresses such as arriving late to work, what to wear for that all-important meeting and the pass-or-fail test that has been studied for weeks. Clinical anxiety, however, can cause people to become irrational and be disabling. It comes in many forms: Generalized Anxiety Disorder (GAD) is the most common type of anxiety. The other types are obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, and social phobia. Anxiety disorder is usually treated with benzodiazepines such as Xanax, Valium or Klonopin, psychotherapy or both. The decision on treatment modality varies so the practitioner and patient's view of what would work best trumps most every other treatment decision.

Depression

• Many people have seen television commercials about depression. The announcer usually says something about a shortage of chemicals in the brain or that the serotonin is not balanced. The recommendation then follows for a medication, which is a serotonin re-uptake inhibitor, also referred to as an SSRI. Paxil, Zoloft, and Lexapro are some of the medications that fall into the SSRI category.

  Serotonin is just one factor that may play a part in depression. Research points to other biological contributions to depression such as stress hormones that are elevated, poor immune system responses, and even shrinking brain cells. While biological causes do exist, social and psychological issues like loneliness, lack of exercise, poor nutritional habits, and low self-esteem also play an enormous role in depression.

There is hope

• The National Institute of Mental Health is conducting clinical trials aimed specifically at a medication called Fluoxetine that addresses both anxiety and depression along with associated changes in the brain. Those studies focus on using Functional Magnetic Resonance Imaging to learn how this drug performs with this population. At this time the study's emphasis is on adolescents. Those involved in this study will continue being followed by the National Institutes of Health until clinician outside of the organization can assume responsibility for follow-up care.