The Best Antidepressants For Treating Comorbid Depression And Anxiety
Most people suffer from both anxiety and depression. They are also more likely to struggle with the comorbidities of the two conditions.
When both anxiety and depression are present, the quality of life, functional impairment, and treatment outcomes tend to be poorer.
The following explores the medications considered to be best suited to treating anxiety and depression.
Apart from medications, patients with anxiety disorder and depression also require psychotherapy, support groups, and other non-pharmacological treatment methods.
Further, it is crucial to manage both acute and chronic symptoms of these disorders. Reducing anxiety symptoms can often lead to easing depression symptoms.
Antidepressants are also used for relaxation as well as treating depression.
Signs And Symptoms Of Anxiety
There are several types of anxiety disorders, including generalized anxiety disorder, , social anxiety disorder, and specific phobias.
For people with anxiety disorders, the anxiety is often persistent and can get worse over time. The symptoms may interfere with their daily life.
Some of the most common signs and symptoms of anxiety include:
- Excessive fear and worry
If you experience these symptoms for six months or longer, you may have an anxiety disorder.
Ok Im Feeling Depressed So Now What
Now that you know the symptoms of depression, some positive coping skills can be useful. All of the following techniques are supported by scientific research and medication prescribers like psychiatrists and these skills are frequently recommended as important parts of treatment even for patients who continue to take antidepressant medications.
WARNING: Do not suddenly go off your prescribed antidepressant medications without first talking to your medical provider. Discuss any questions or concerns about the side effects of your medications with your provider.
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How Are Antidepressant Medications Selected
The type of drug prescribed will depend on your symptoms, the presence of other medical conditions, other medicines you are currently taking, the cost of the prescribed treatments, and potential side effects. If you have had depression before, your provider may prescribe the same medicine that worked for you in the past. If you have a family history of depression, medicines that have been effective in treating your family member may also be considered.
Usually you will start taking the medicine at a low dose. The dose will be gradually increased until it has reached the therapeutic dose, or until you start to see an improvement .
Selective Serotonin Reuptake Inhibitors
Selective serotonin reuptake inhibitors are a commonly prescribed class of antidepressants. Taking these drugs doesnt cause significant side effects, even at higher dosages. They can help to alleviate mild to moderate depression.
Selective serotonin reuptake inhibitors, or SSRIs as theyre commonly referred to, target only serotonin. These antidepressants prevent serotonin from getting absorbed back into neurons.
Consequently, this increases the brains supply of available serotonin, enhancing a persons mood and outlook on life.
The effect of SSRIs on anxiety is often described as turning down the volume on anxious thoughts.
It may have similar or higher effects to practicing mindfulness and participating in psychotherapy.
Apart from reducing physiological symptoms of depression and anxiety , SSRIs may also reduce psychological symptoms.
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Managing Anxiety And Depression
A therapist can offer more guidance on treatment options for anxiety and depression, but you can also take steps to cope with symptoms on your own.
The strategies below may not always help, but trying different approaches at different times can help you learn more about what works for you. That insight can guide you toward a personalized toolbox of coping strategies, so you always have options to consider when feeling distressed or overwhelmed.
Your therapist can also offer suggestions for new strategies to try, plus offer tips on putting them into practice.
Aim To Get A Good Nights Sleep
Not enough sleep can worsen symptoms of both anxiety and depression but too much sleep can also affect well-being and mood.
Experts recommend most adults get
These tips can help you get the sleep you need:
- Make a habit of going to bed and getting up around the same time each day.
- Turn off electronic devices about 1 hour before bedtime.
- Create a soothing ritual that helps you wind down before bed.
- Keep your bedroom dark, cool, and quiet.
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Allow Yourself To Feel What Youre Feeling
Depression and anxiety are medical conditions, not the result of failure or weakness, and theyre absolutely not your fault.
Without a doubt, the unwanted emotions they cause can lead to plenty of distress. But knowing depression and anxiety result from underlying causes and triggers, not anything you did or didnt do, can promote self-compassion instead of criticism or self-punishment.
Looking After Someone Who Has Depression
If you’re close to someone with depression, their condition can affect you too. Your relationship, and family life in general, can be strained, and you might not know what to do or how to help.
Talking about the situation can help. Finding a support group, or talking to other people in a similar situation, can make it easier to cope. If the condition is causing difficulties in your relationship with your partner, you could contact a relationship counsellor who can talk things through with both of you.
When suffering from depression, men are less likely to ask for help than women. They’re also more likely to turn to drugs and alcohol to cope with the symptoms.
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What Medications Are Used To Treat Anxiety Disorders
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs ,Ã Ã have been shown to be effective.
Other anti-anxiety drugs include the benzodiazepines, such as as alprazolam , diazepamÃ , buspirone ,Ã and lorazepam . These drugs do carry a risk of addiction or tolerance , so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability. Some anticonvulsant drugs , some blood pressure medications , and some atypical antipsychotics are also occasionally used “off label” to treat anxiety symptoms or disorders.
What Are The Side Effects Of Antidepressant Medications
The provider prescribing your medicine will discuss its potential side effects with you. He or she will try to prescribe drug with the least number of side effects for your health condition. Sometimes, more than one medicine may be tried before the desired benefits are achieved.
You will be monitored closely so that your provider can detect the development of harmful side effects and make the necessary changes.
All medications not just antidepressants can cause side effects. Keep in mind that your provider prescribes the medication only if its expected benefits outweigh the risk of side effects.
Side effects, if they occur, are usually mild. Some side effects decrease after you have taken the drug for a while. However, if side effects don’t go away, they will once the drug is stopped. Be sure to discuss your concerns with your provider before taking any medicine.
Classes of antidepressant medications and common side effects
Currently there are six different classes of medications approved to treat depression. These are:
- Selective serotonin reuptake inhibitors .
- Serotonin and noradrenaline reuptake inhibitors .
- Tricyclic antidepressants .
- Norepinephrine and dopamine reuptake inhibitors .
- Non-competitive N-methyl-D-aspartate receptor antagonists.
Selective serotonin reuptake inhibitors
- Increased sweating.
Non-competitive N-methyl-D-aspartate receptor antagonists
- Feeling drunk.
- Lack of energy.
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What Is Clinical Depression
Depression exists on a continuum of severity, ranging from relatively mild, transient states of low mood to severe, long term symptoms that have a major impact on a persons quality of life. When a persons symptoms have reached the chronic end of the spectrum and require professional treatment, it’s typically referred to as clinical depression.
Although depression can take on many forms and may be categorized in several different ways, there are two primary types of clinical depression as defined by the Diagnostic and Statistical Manual of Mental Disorders: major depressive disorder and the depressive phase of bipolar disorder.
Mental Health Conditions: Depression And Anxiety
Depression is more than just feeling down or having a bad day. When a sad mood lasts for a long time and interferes with normal, everyday functioning, you may be depressed. Symptoms of depression include:1
- Feeling sad or anxious often or all the time
- Not wanting to do activities that used to be fun
- Feeling irritable easily frustrated or restless
- Having trouble falling asleep or staying asleep
- Waking up too early or sleeping too much
- Eating more or less than usual or having no appetite
- Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
- Having trouble concentrating, remembering details, or making decisions
- Feeling tired even after sleeping well
- Feeling guilty, worthless, or helpless
- Thinking about suicide or hurting yourself
The following information is not intended to provide a medical diagnosis of major depression and cannot take the place of seeing a mental health professional. If you think you are depressed talk with your doctor or a mental health professional immediately. This is especially important if your symptoms are getting worse or affecting your daily activities.
The exact cause of depression is unknown. It may be caused by a combination of genetic, biological, environmental, and psychological factors.2 Everyone is different but the following factors may increase a persons chances of becoming depressed:1
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Which New Anxiety Medications Are You Most Excited About
If youve reviewed the new anxiety medications in development that were mentioned above, leave a comment below with your thoughts. Which new anxiety medications are you most excited about? Are there any medications in development that you think have greater therapeutic potential than others? Are there any medications in development that you arent excited about?
Personally, Im most intrigued by NBTX-001 which consists of the noble gas xenon and acts as an NMDA receptor antagonist. I suspect that action on the NMDA receptor could yield rapid-acting and protracted anxiolytic effects . Im also interested in following SRX246 which function as a vasopressin 1A receptor antagonist. Moreover, Im curious as to whether Janssen will reinstate JNJ-42165279 trials or if the development will end up permanently shelved.
The Aloradine nasal spray comprised of a synthetic pheromone seems great on the surface, but its action is similar to many available medications , possibly resulting in rapid tolerance onset and/or deleterious long-term effects akin to benzodiazepine treatment. Nevertheless, both Aloradine and Tonmya are already in Phase III clinical trials and could hit the market sooner than expected.
How Long Will It Take For Them To Take Effect
According to the United Kingdoms National Health Service , people may begin to feel the benefits of the antidepressants after 12 weeks if the person has not missed a dose.
Some people may stop taking them because they believe the medications are not working. However, it is important to keep taking the medication exactly as their doctor has prescribed.
If a person has not felt any benefit after 4 weeks, they should speak with a doctor.
According to the NHS, doctors will typically suggest a person takes antidepressants for at least 6 months.
People should take their antidepressants exactly as their doctor has prescribed.
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How Long Should I Be On Antidepressants
Most people are advised to keep taking their antidepressant for at least 6 to 12 months after they start to feel better, to reduce the risk of symptoms returning. Itâs important to discuss with your doctor about the best time to stop an antidepressant.
In some people, ongoing antidepressant treatment is recommended to maintain long-term control over their illness.
Ketaminefrom Anesthetic To Depression Miracle Drug
Interestingly, studies from Yale research labs showed that the drug ketamine, which was widely used as anesthesia during surgeries, triggers glutamate production, which, in a complex, cascading series of events, prompts the brain to form new neural connections. This makes the brain more adaptable and able to create new pathways, and gives patients the opportunity to develop more positive thoughts and behaviors. This was an effect that had not been seen before, even with traditional antidepressants.
I think the interesting and exciting part of this discovery is that it came largely out of basic neuroscience research, instead of by chance, says Gerard Sanacora, MD, PhD, a psychiatrist at Yale Medicine who was also involved in many of the ketamine studies. It wasnt just, Lets try this drug and see what happens. There was increasing evidence suggesting that there was some abnormality within the glutamatergic system in the brains of people suffering from depression, and this prompted the idea of using a drug that targets this system.
This is why Dr. Sanacora believes that ketamine may be most effective when combined with cognitive behavioral therapy , a type of psychotherapy that helps patients learn more productive attitudes and behaviors. Ongoing research, including clinical trials, addressing this idea are currently underway at Yale.
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Different Types Of Depression
There are different types of depression, and there are some conditions where depression is a symptom. These conditions include:
- Bipolar disorder people with bipolar disorder, which is also known as “manic depression”, experience times of depression, where the symptoms are similar to clinical depression. They also go through phases when they have excessively high moods . Bouts of mania can include harmful behaviour like unsafe sex, spending sprees and gambling.
- Seasonal affective disorder is also called “winter depression”. It’s depression that is related to weather, usually winter, so it happens seasonally.
- Postnatal depression happens to some women after they’ve had a baby. It’s treated similarly to other types of depression, with antidepressant medication and talking therapy.
Learn more about how depression is diagnosed here.
What Do Antidepressant Medications Do
Antidepressant medications increase the activity of chemicals called neurotransmitters in the brain. Increasing the activity of the neurotransmitters serotonin, norepinephrine and dopamine seems to help lessen the symptoms of depression and anxiety. However, the brain is a very complex organ and the reasons why these drugs work are not yet fully understood.
We do know that these drugs help to relieve symptoms of depression and anxiety in up to 70 per cent of people who try them. This rate is even higher when people who dont get relief with one type of antidepressant try a second type.
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Noradrenaline And Specific Serotonergic Antidepressants
Because completely new drugs take a long time to be developed which doesnt happen very often there needs to be a way for people to find alternative options.
In these cases, a small modification of an existing drug may provide the solution. NaSSAs are a modification of SNRIS.
When needed, Noradrenaline and Specific Serotonergic Antidepressants are used for different illnesses that affect similar biological systems in the body.
Specifically, NaSSA stimulates an increased release of norepinephrine, serotonin, and dopamine in the synaptic clefts .
How Do Antidepressants Work
Various antidepressant medications are available for prescription use. There is no single best antidepressant, and the best one for you depends on your symptoms and individual needs.
Usually, antidepressants help balance the levels of neurotransmitters, which are chemicals responsible for communications between neurons in the brain. These chemicals include serotonin, dopamine and norepinephrine. Higher levels of these chemicals usually correspond with lower levels of depression.
While antidepressants can be helpful in depression, effectiveness varies from patient to patient. How long the drugs stay in your body also varies. Some drugs stay in your body for about 36 hours, while others last as long as several days.
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Seeing A Doctor About Depression
Big changes in your life, like bereavement, losing a job, or even having a baby, can cause symptoms of depression. You’re also more likely to experience depression if you have a family history of depression. However, it’s also possible to become depressed without there being an obvious reason.
You can learn more about depression causes here.
If You Feel Better Can You Stop Taking Antidepressants
Once you and your provider have determined it is safe for you to stop taking your medicine altogether, you should continue to be monitored during periodic follow-up appointments to detect any signs of depression returning.
Long-term treatment with antidepressant medicine may be recommended to prevent further episodes of depression in people who have already had two or more episodes of major depression. A history of depression in ones family is another factor that supports long-term treatment.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2019.
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What About Prescription Medication And Treatments For Anxiety And Depression
More info on this topic
According to Henry Emmons in his book TheChemistry of Joy, you should consider taking medications if you have any of the following symptoms:
- Severe depression that makes it hard to function in daily life or is accompanied by suicidal or self-destructive thoughts
- Moderate depression that has not improved within three to four weeks of trying natural therapies
- Mild depression that has not improved within six to eight weeks of trying natural therapies
- A severe sleep disturbance that does not improve with natural therapies
- Repeated episodes of depressions, especially if they occur without any particular trigger
Treatment Considerations For Comorbid Anxiety And Depression
Resolving anxiety quickly should be the first goal of treatment in patients with anxiety and depression.61 Once this objective is accomplished, patients are much more likely to remain compliant with their antidepressant regimen and to continue their therapy for the full duration necessary to achieve complete remission of their depression.
One choice for pharmacotherapy in patients with comorbid anxiety and depression is the combination of a BZD or buspirone with an antidepressant. Alternatively, some patients may respond to antidepressant therapy alone, provided a drug that is effective in treating both disorders is used. Because the traditional anxiolytics will have little if any effect on depression, an adequate course of therapy with an antidepressant is imperative.62 On the other hand, in patients treated with an antidepressant plus an anxiolytic, the clinician may consider tapering the anxiolytic slowly, then discontinuing it when the symptoms of acute anxiety have resolved.61 Because of their well-documented withdrawal effects, the BZDs should be tapered gradually over the course of at least several weeks, depending on the dosage and duration of BZD therapy.
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