Anxious depression occurs when a person with depression also has symptoms of anxious distress. Unfortunately, people with anxious depression often struggle to get symptom relief. Their symptom improvement may take longer to achieve and may not seem to last. Symptoms of anxious distress make this type of depression more challenging to treat, but several medications have been shown to help. Here are some of the most effective and commonly used medications for anxious depression.
It’s not fully understood why, but people with this type of depression may only get partial symptom relief from antidepressants and are more likely to experience side effects. People with anxious depression also tend to have more health problems and other stressors, which may be related to more difficulty with symptoms.
Antidepressants are commonly used for many types of depression. A few anxiety and antipsychotic medications can also provide relief, sometimes in combination with antidepressants.
As with all forms of medications, it is imperative to consult with a licensed mental health expert when considering a certain type of treatment. Psychopharmacology can offer significant relief but can also come with side effects that may be hard to tolerate. Consult with your doctor to gain a comprehensive understanding of this form of therapy.
Antidepressants have been used to treat depression symptoms for several decades. The oldest type of antidepressants helped with symptoms but came with many unpleasant side effects. In later years, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) were developed.
SSRIs and SNRIs work by blocking nerve cell receptors for specific neurotransmitters. Blocking the receptors leaves more of the neurotransmitters available to move freely between nerve cells, improving a person’s symptoms. These medications offer effective symptom relief with fewer discomforts or safety concerns.
SSRIs and SNRIs were designed primarily to treat depression, but they can also help with symptoms of anxiety. This dual effect has made them a primary treatment for depression with anxious distress.
SSRI antidepressants work by preventing the neurotransmitter serotonin from being reabsorbed. Higher levels of serotonin activity are associated with a positive mood. So, when a person has symptoms of depression, these medications help by increasing the activity again. As a person’s mood improves, they may function better and learn other ways of coping with their distress.
These medications have some side effects, including weight gain, sleep problems, and sexual dysfunction. For some individuals, these effects are too adverse for them to continue using SSRIs. But these medications are generally safe and helpful for most people who try them.
SNRI antidepressants were developed in the1990s to offer benefits of existing medications with fewer side effects. SNRIs work by targeting both the serotonin and norepinephrine pathways. Like SSRIs, SNRI antidepressants block receptors on nerve cells to increase serotonin and norepinephrine activity. This approach may offer some better relief of symptoms by engaging more than one neurotransmitter.
Benzodiazepines are not typically the first medications used to treat anxious depression. They often cause significant side effects and have the potential for misuse, especially with longer periods of use. Benzodiazepines can trigger a dopamine release much like opioids and other addictive substances. This reward response is what creates the risk for misuse for vulnerable individuals. But when studies compared benzodiazepines and more traditional antidepressants, both were effective.
Anxious depression symptoms tend to be less responsive to treatment. So, identifying treatments that may help is important, even if they are a less commonly prescribed option such as benzodiazepines. Choosing a type with lower risk of misuse, such as clonazepam, can make benzodiazepines a potential treatment option. The FDA added new labeling information for Xanax (alprazolam) stating that anxiety associated with depression is responsive to the medication.
When a person’s antidepressant becomes less effective, they may need a combination of medications to get more complete symptom relief. This approach may be more helpful because it addresses more than one type of neurotransmitter system. Antipsychotic medications such as aripiprazole and quetiapine can be used with antidepressants. Some antipsychotic medications have significant side effects, so they may not be the right fit for everyone.
Azapirones are a newer class of anti-anxiety medication, with buspirone as the only one currently in use as a treatment. Buspirone is often used along with SSRI and SNRI antidepressants or if an individual cannot tolerate these medications. It relieves symptoms by affecting the serotonin pathway. Also, buspirone carries no risk of misuse or dependence, no withdrawal symptoms, and no sedative effects.
Since depression is the primary diagnosis with anxious depression, traditional antidepressants are typically used first. They have anxiolytic properties that can effectively improve anxiety symptoms. But azapirones have shown promise as an effective option for anxious distress. They also have less impact on a person’s sensory processing and are less sedative. Gepirone and Tandospirone are two that have shown positive outcomes for anxious depression.
It can be challenging to get effective symptom relief for anxious depression. A person coping with symptoms will need to evaluate the benefits and drawbacks of any medication they consider, but there are many ways to find relief.
