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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Medications for Anxiety that Accompanies Depression


September 09, 2011

Depression
8596
What Kind Of Treatment Is Available?
Medications for Anxiety that Accompanies Depression
Medications for Anxiety that Accompanies Depression
htmAntianxietyDrugs
Anxiety commonly accompanies depression. Fortunately, many good, safe drugs are available to treat anxiety.
363059
InteliHealth
2011-09-09
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InteliHealth/Harvard Medical Content
2014-09-09

Reviewed by the Faculty of Harvard Medical School

Medications for Anxiety that Accompanies Depression
 
Anxiety commonly accompanies depression. There are several good treatment strategies that can help.
 
Many of the antidepressant medications also treat anxiety and can reduce or eliminate the symptoms. Examples include:
Benzodiazepines, when used appropriately, are often useful. However, regular use of benzodiazepines can make depression worse. So they should only be taken as prescribed by your doctor or therapist. Intermittent use of small doses is usually safe.
 
 
Buspirone also has antianxiety effects. Unlike benzodiazepines (and more like antidepressants), buspirone can take several weeks to work. It needs to be taken daily.
Benzodiazepines
 
Benzodiazepines have been used since the early 1960s.
These drugs boost the activity of gamma-aminobutyric acid (GABA). GABA is an "inhibitory neurotransmitter," meaning it slows down the transmission of nerve impulses. Most are sedating.
 
 

Generic Name

Brand Name

Dose*

Alprazolam
Xanax
0.25-1 milligram
Chlordiazepoxide
Librium
5-25 milligrams
Clonazepam
Klonopin
0.25-1 milligram
Diazepam
Valium
2-10 milligrams
Lorazepam
Ativan
0.5-2 milligrams
Oxazepam
Serax
10-30 milligrams

 

*The usual dose is one to two times per day. In rare situations, your doctor may prescribe the medication up to three or four times per day.
 
Benzodiazepines are relatively safe. They can reduce or relieve anxiety symptoms quickly. At higher doses, they are sedating. They are often used as a sleep aid.
 
Common side effects are sedation and poor concentration. Some people find the benzodiazepines make them clumsy or uncoordinated. These problems can usually be addressed by reducing the dose. Disorientation can occur. This effect is more likely in elderly people. Some benzodiazepines, particularly those that enter and leave the system very quickly, can cause amnesia. You may forget events on the morning or day after you take the drug.
 
Continuous daily use of a benzodiazepine can lead to physical dependence on the drug, and the possibility of withdrawal symptoms if you stop taking it suddenly. Benzodiazepines should be discontinued gradually, with your health-care provider's help.

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Buspirone
 
Buspirone (BuSpar) usually takes at least a week or two to work. It may be less effective for people who have already experienced immediate relief from a benzodiazepine.
The starting dose is usually 5 milligrams twice or three times per day, which can be gradually increased to 60 milligrams per day as needed.
 
Common side effects are nausea, headache, nervousness, dizziness and lightheadedness. Buspirone is not as sedating as benzodiazepines. Nor does it cause physical dependency. However, fewer people find buspirone effective compared with benzodiazepines. Other side effects may occur. If you notice any changes after you start taking buspirone, check with your health-care professional.

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