Use of Antidepressants in Anxiety

Many patients with anxiety also have symptoms of depression.47 It therefore seems reasonable to include antidepressant drugs as part of the pharmacological regimen in these patients. Hence, patients with a combination of anxiety and depression often take a traditional antianxiety agent such as a benzodiazepine along with an antidepressant.44 The pharmacology of the antidepressants is addressed in Chapter 7. 

Antidepressant drugs, however, might have direct anxiolytic effects. That is, certain antidepressants such as paroxetine (Paxil) or venlafaxine (Effexor) can help reduce anxiety independent of their effects on depression.1,47 These antidepressants have therefore been advocated as an alternative treatment for anxiety, especially for people who cannot tolerate the side effects of traditional anxiolytics, or who might be especially susceptible to the addictive properties of drugs like the benzodiazepines.1,9,46 Moreover, antidepressants such as paroxetine or venlafaxine are now considered effective as the primary treatment for several forms of anxiety, including generalized anxiety disorder, social phobia, and panic disorder.4,29,53 Antidepressants, either used alone or in combination with antianxiety drugs, have become an important component in the treatment of anxiety. 

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