BENZODIAZEPINES FOR DEPRESSION - A REVIEW OF THE LITERATURE

The English language literature on the use of benzodiazepines in depre ssive disorders was reviewed. We selected double-blind random assignme nt studies in which benzodiazepines were compared with reference drugs and/or placebo. Comparative studies with classical (non-triazolo) ben zodiazepines in major depression show that these agents do not allevia te the core symptoms of depression, although they do have an effect on sleep and anxiety, Classical benzodiazepines show some efficacy in mi nor depression, but this conclusion could be related to efficacy in pa tients suffering from anxiety disorders rather than depression, Triazo lo-benzodiazepines, mainly alprazolam, have been found to be effective in mild to moderate depression, although they turned out to be inferi or to tricyclic antidepressants (TCAs) in patients with endogenous or melancholic depression, Furthermore it Is questionable whether triazol o-benzodiazepines cause amelioration of the core symptoms of depressio n. With regard to combination therapy benzodiazepines may contribute t o antidepressant response in the first weeks, because of a faster onse t of effect than TCAs and/or because of effects on different symptoms. Beyond the first weeks of treatment combination therapy does not seem superior to monotherapy with TCAs.