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    Doctors Target Two Brain Chemicals to Treat Depression, Anxiety


    WebMD Health News
    Reviewed by Gary D. Vogin, MD

    Sept. 17, 2001 -- Many people with depression also experience some degree of anxiety, which can include excessive worrying, heart palpitations, sweating, and stomach ills. When these complications happen, mental health symptoms can be more severe, and the road to recovery can be even rockier than when depression or anxiety occurs alone.

    A recent study suggests that a currently available drug, sold under the brand name Effexor, may be more helpful for these people than another commonly available medication.

    Effexor XR, the form of the drug that is released into the body over a long period of time, acts on two brain chemicals affecting both depression and anxiety. It recently was found to provide greater improvements in anxiety and depression, compared to both Prozac and a dummy pill given for about three months. These results were reported in the July issue of the Journal of Clinical Psychiatry.

    Prozac works by increasing the availability of the mood chemical serotonin, while Effexor targets serotonin and norepinephrine, another brain chemical that plays a role in anxiety and depression.

    "This is the first study to show a difference, and I am pleased with the results because it's nice to see a difference that you can determine between the medications," says study author Peter Silverstone, MD, a professor of psychiatry at the University of Alberta in Edmonton.

    "This adds to the growing body of evidence that dual-action drugs or treatments are significantly better in treating a range of psychiatric disorders," he tells WebMD.

    Silverstone and colleague Eliseo Salinas, MD, of Wyeth-Ayerst Research in Paris, looked at the effects of Effexor, Prozac, or a dummy pill among 92 people with both major depression and generalized anxiety disorder and 276 people with depressive disorder. For people with depression and anxiety, a medication that targets two brain chemicals may be more effective than a drug that only targets one chemical.

    Generalized anxiety disorder is marked by persistent, irrational worry. While realistic worry may be expressing financial concern after losing a job, unrealistic worries generally begin with "what if" and are followed by a slew of unlikely concerns or scenarios -- What if I do something embarrassing in a social setting? What if my heart never stops racing?

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