Management of Patients With Depression Associated With Anxiety Symptoms

Current diagnostic classifications separate depression from anxiety, yet these conditions commonlycoexist in clinical practice, forming a spectrum of disorders between these extremes. Treatmentoptions for depression with anxiety include tricyclic antidepressants (TCAs) and serotonin selectivereuptake inhibitors (SSRIs). As SSRIs are nonsedating, this proves that sedation as produced by TCAsis not required for anxiolytic actions. SSRIs are effective in anxiety disorders and against anxietysymptoms in depressed patients. The adverse event profile of SSRIs compares favorably with that ofTCAs, and SSRIs are much safer in overdose. When the diagnosis of depression with anxiety is established,it is important to institute prompt, effective treatment in view of the potential risk of suicide.The SSRIs appear to be the treatment of choice for such patients.