Drug Options for Treating Depression and Anxiety Disorders

Anxiety and depression are two of the most common mental health disorders in the US. Moreover, it’s common to have both anxiety and depression at the same time. Statistics indicate that nearly 50% of people diagnosed with anxiety disorder are also diagnosed with depression.

However, even if you receive this dual diagnosis, you won’t necessarily need to double the treatment. Some medications treat both anxiety and depression. Your healthcare provider will work closely with you to determine the right treatment plan for your specific needs.

Diagnosing Anxiety and Depression

Depression and anxiety disorders are different, but they often occur simultaneously. Depression is a mood disorder that is associated with feelings of helplessness, worthlessness, and hopelessness. According to WHO, about 280 million people in the world experience depression at some point in their life. Depression is not uncommon; it can last a week or several years and cause you to feel sad, devastated, and unable to enjoy your life. On the other hand, anxiety disorders are characterized by excessive worry, nervousness, or fear that interferes with our everyday lives. If left untreated, anxiety disorders can become even worse over time. There are many different kinds of anxiety disorders, each with its own set of symptoms — for example, a generalized anxiety disorder (GAD). About 2.7% of adults with GAD in the US experience severe symptoms that include intense fear and worry that are difficult to control.

Symptoms of Anxiety and Depression

Diagnosing patients with both depressive and anxious symptoms should be done carefully. While both depression and anxiety disorders are similar, anxiety encompasses a wide range of symptoms seen in various mental illnesses. Some people feel anxious when they are depressed, but depression is not considered a symptom of anxiety. Depression and anxiety symptoms may also include feelings of avoidance and avoiding activities that people enjoyed before, changes in appetite or headaches, and feeling tired. People who are depressed often feel low energy, have low motivation, and think about doing self-harm repeatedly. Moreover, patients with an anxiety disorder may experience constant fear and worry.

Anxiety and Depression Medications

Many medications can help people with anxiety and depression. Some of the antidepressants listed below can help patients with a social anxiety disorder or generalized anxiety disorder. Antidepressants affect the way the brain processes certain neurotransmitters, like serotonin or norepinephrine. Depending on which disorder a patient has, the most effective depression and anxiety meds will vary.

Common medications for depression and anxiety are discussed below.

SSRIs

SSRIs and SNRIs are generally prescribed for people who have a generalized anxiety disorder (GAD) or depression. SSRIs are a class of medications that have a wide therapeutic range. Many people take SSRIs to treat their anxiety or to alleviate their depression. These medications block serotonin’s reuptake in the brain and increase the amount of serotonin in the brain, which improves mood. Common SSRIs that are used for depression and anxiety disorders include:

• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Escitalopram (Lexapro)
• Paroxetine (Paxil, Pexeva)
• Fluvoxamine (Luvox)

Side Effects of SSRIs

Common side effects reported by patients using SSRIs are:

• Dizziness
• Blurred vision
• Dry mouth
• Stomach problems
• Changes in appetite
• Sleeping issues
• Sexual problems

SNRIs

SNRIs are similar to SSRIs in that they block the process by which serotonin is reabsorbed in the brain and increase serotonin levels. SNRIs, however, also increase norepinephrine, which is a key component of the brain’s stress response. Common SNRIs include:

• Desvenlafaxine (Pristiq, Khedezla)
• Venlafaxine (Effexor XR)
• Duloxetine (Cymbalta, Irenka)
• Milnacipran (Savella)
• Levomilnacipran (Fetzima)

Side effects of SNRIs

Common side effects associated with SNRIs are:

• Headaches
• Excessive sweating
• Nausea
• Changes in sleep and appetite
• Sexual Dysfunction

Do you have the symptoms of depression or anxiety? Join Mango Clinic to consult with a licensed mental health professional.

Tricyclic Antidepressants (TCAs)

TCAs increase serotonin and norepinephrine levels in the brain and therefore improve mood. They block the actions of the neurotransmitter acetylcholine. Examples of drugs belonging to TCAs include:

• Amitriptyline (Elavil)
• Desipramine (Norpramin)
• Amoxapine (Asendin)
• Doxepin (Silenor)
• Imipramine (Tofranil)
• Nortriptyline (Pamelor)
• Protriptyline (Vivactil)
• Trimipramine (Surmontil)

However, TCAs can cause more severe side effects (like high blood pressure, heart problems, weight gain, and diarrhea) than other antidepressants. They are not considered first-line treatments for patients with depression and anxiety disorders.

MAOIs

MAOIs are used to treat depression; they can also be prescribed for panic disorder and social anxiety disorders. MAOIs work by blocking the action of the monoamine oxidase enzyme in the brain, which is responsible for breaking down different neurotransmitters in the brain, including norepinephrine, serotonin, dopamine, and tyramine. As a result, the amount of these neurotransmitters in the brain increases, alleviating depression. FDA-approved MAOIs include:

• Isocarboxazid (Marplan)
• Tranylcypromine (Parnate)
• Selegiline (Emsam, Zelapar)
• Phenelzine (Nardil)

MAOIs cause more severe side effects (skin reactions, jerky movements, hypotension, and serotonin syndrome) than other antidepressants, and so they should be used only for those who have tried other antidepressants and have not had any improvement.