Antidepressant drugs anxiety

Antidepressant drugs are used to manage depressive episodes such as major depression or depression accompanied by anxiety. These drugs may be used in conjunction with psychotherapy in severe depression. The SSRIs also are used to treat obsessive-compulsive disorders. The uses of individual antidepressants are given in the Summary Drug Table Antidepressants. Treatment is usually continued for 9 months after recovery from the first major depressive episode. If the patient, at a later date, experiences another major depressive episode, treatment is continued for 5 years, and with a third episode, treatment is continued indefinitely. 

Gnkgo (maiden hair tree, kew tree) Ginkgo biloba Raynauds disease, cerebral insufficiency anxiety, stress, tinnitus, dementias, circulatory problems, asthma Rare if used as directed possible effects include headache, dizziness, heart palpitations, Gl effects, rash, allergic dermatitis Do not take with antidepressant drugs, such as the MAOIs, or the antiplatelet drugs such as coumarin, unless advised to do so by the primary care provider. 

Owens, M. J. (1997). Molecular and cellular mechanisms of antidepressants drugs. Depress. Anxiety, 4, 153-9. 

Blier P., Abbott F. V. (2001). Putative mechanisms of action of antidepressant drugs in affective and anxiety disorders and pain. J. Psychiatry Neurosci. 26, 37-43. 

Sandler M (1992). Development of anxiolytic and antidepressant drugs A historical perspective. In JM Elliot, DJ Heal and CA Marsden (eds), Experimental Approaches to Anxiety and Depression (pp. 1-8). John Wiley Sons, Chichester, UK. 

Antidepressant drugs, such as the tricyclic antidepressants and the selective serotonin reuptake inhibitors (SSRIs), are very important for the treatment of psychotic depression (see Chapter 34). They have been shown to be effective when used in the treatment of several anxiety disorders, including general anxiety, obsessive-compulsive disorder, and several phobias, including agoraphobia. Because the SSRIs are less toxic than the tricyclic antidepressants, their use in the treatment of anxiety is safer and less likely to produce serious side effects. 

Also in the 1950s and early 1960s, serotonin and dopamine were discovered to be neurotransmitters (later we will explore how these neurotransmitters are targets for anxiety-reducing drugs). Moreover, research into the first antidepressant drugs was suggesting links between neurotransmitters and mood. 

Modigh K Antidepressant drugs in anxiety disorders. Acta Psychiatr Scand 76 [suppl 335) 57-71, 1989... 

Papadimitriou GN, Kerkhofs M, Kempenaers C, et al EEG sleep in patients with generalized anxiety disorder. Psychiatry Res 26 183-190, 1988 Papadimitriou GN, Christodoulou GN, Katsouyanni K, et al Therapy and prevention of affective illness by total sleep deprivation. J Affect Disord 27 107-116, 1993 Papp M, Muscat R, Willner P Additive effects of chronic treatment with antidepressant drugs and intermittent treatment with a dopamine agonist. Eur Neuropsy-chopharmacol 2 121-125, 1992... 

Stabel S, Parker PJ Protein kinase C. Pharmacol Ther 51 71-95, 1991 Stagno SJ, Smith ML, Hassenbusch SJ Reconsidering psychosurgery issues of informed consent and physician responsibility. J Clin Ethics 5 217-223, 1994 Stahl SM Is serotonin receptor down regulation linked to the mechanism of action of antidepressant drugs Psychopharmacol Bull 30 39-43, 1994 Stahl SM Mixed anxiety and depression serotonin 1A receptors as a common pharmacological link. J Chn Psychiatry (in press)... 

As indicated in Chapter 1 some antidepressant drugs, particularly SSRIs and SNRIs, are being used increasingly for the pharmacotherapy of anxiety... 

Beta-adrenoceptor antagonists, particularly propranolol, have been shown to be effective for anxiety symptoms particularly in situational anxiety and GAD. Buspirone, an azaspirodecanedione, is an agonist at 5-HTlA receptors and seems to have anxiolytic effects, though it is less potent than the BDZs and the effects take up to three weeks to become evident. There is high first pass metabolism and a considerable proportion of the effect is due to a metabolite (1-PP). The principal adverse effects of buspirone are nausea, gastrointestinal upset and headache. Antidepressant drugs, both the older tricyclic antidepressants and the newer drugs, have been demonstrated to have anxiolytic effects in mixed anxiety-depressive patients, GAD and panic disorder. 

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