Doctors Target Two Brain Chemicals to Treat Depression, Anxiety
"Most people with depression will also have anxiety, and the issue is whether it is a separate disorder," says Ira D. Glick, MD, a professor of psychiatry at Stanford University School of Medicine in Palo Alto, Calif. As many as 90% of people with depression suffer from some symptoms of anxiety, and the two conditions also have certain overlapping symptoms, such as difficulty sleeping, fatigue, restlessness, and difficulty concentrating.
Once a doctor has determined whether the two are distinct problems, the good news is that "we have many more choices with drugs with better side-effect profiles today that help patients and families cope with crippling depression and anxiety that can cause great distress throughout life," he says.
Most drugs take about four to six weeks to kick in, he says.
"There is hope," he says. "These [drugs] do help, and they can be taken for a lifetime."
Effexor also appears to help middle-aged and older women cope with anxious depression as they adjust to menopause, according to research presented at the World Assembly for Mental Health in Vancouver, British Columbia.
Anxiety and depression are inextricably linked, says David Baron, MSed, DO, professor and chairman of the department of psychiatry at Temple University School of Medicine in Philadelphia.
"A patient who appears depressed one day may be anxious a week later, so specific labeling isn't that important," he says.
"Depression has a gradual onset and offset, but anxiety is more like a rock in your shoe -- you know right away," he says. That's why it's important to stay on antidepressants long enough to see them work.
What's important is that "we have a lot of compounds, and they all work. They just don't all work in everybody, [so] don't go chasing the best drug. The best drug is the one that works for you."
In general, Baron says, a combination of medication and talk therapy usually is best.