Treatment of anxious-depressive disorders - newer therapeutic approaches

Patients with symptoms of anxiety and depression are often seen in clinical practice. Following diagnostic criteria of DSM-III/IV or ICD-10 patients with different symptom constellations and degrees of illness can be differentiated, from patients with subthreshold anxiety or depression to patients with comorbid anxiety disorder and depressive disorder. The diagnostic problems and epidemiological aspects of these comorbid disorders and pharmacotherapeutic strategies are discussed. It could be demonstrated that different selective serotonin reuptake inhibitors are equal to tricyclic antidepressants in their anxiolytic effect, but in view of fewer side effects SSRI can be seen as therapy of the first choice. Newer antidepressivants are discussed in respect of their anxiolytic effect Especially nefazodone with its sedative component can be seen as a possible alternative to TCA and standard SSRI in the treatment of these patients.