-Abstract-
Anxiety symptoms and disorders frequently coexist in patients with major depression.
Two conditions show extensive overlap with respect to symptomatomatology and a
spectrum of disorders. The majority of patients were found to have mixed
anxiety-depressive syndrome (42.3%) or depression with comorbid anxiety (19.2%), with
only 12.8% of the population having anxiety alone and 10.3% having depression alone.
Moreover, the diagnosis of two disorders can be exchanged sometimes. Thus, anxiety
and depression can not think over as a completely separate entities, especially for the
treatment of two disorders. The presence of anxiety symptoms or disorders has been
found to be associated with increased severity and poorer outcomes of depression,
including an increased risk of suicide, higher helplessness, poorer prognosis, more
chronic course, more functional and psychosocial impairment. However, there is no
confirmative pathogenesis, for the anxious depression. Maybe it is supposed to the
interactions of the neurotransmitters, especially serotonin and norepinephrine. All the
antidepressants and anxiolytics can be used for the treatment of anxious can be used
for the treatment of anxious depression, eventhough venalfaxine, mirtazapine & SSRIs
were recommended for the first choice recently. However, TCAs and benzodiazepines
have some limits in the adverse effects, addiction and the risk of suicide. Thus,
benzodiazepines have to be used as a adjunctives or shortterm trial for the control of
anxiety. Cognitive behavioral therapy is useful way to treat the anxious depression,
however, it might be effective in the case of combination with pharmacotherapy. St.
John's wort as a herbal medicine, rapetitive Transcranial Magnetic Stimulation (rTMS),
Vagus Nerve Stimulation (VNS) may be applied in the future time.
|