Overview of antidepressants currently used to treat anxiety disorders

The syndromes of anxiety and depression may reflect separate disorders with overlapping symptoms. They also may be comorbid or reflect illnesses with similar underlying pathophysiology based upon a spectrum of central nervous system dysfunction. Antidepressants effectively treat both anxiety and com orbid anxiety-depression Tertiary tricyclic antidepressant agents (TCAs) wi th dual seratonergic-noradrenergic effects, such as imipramine and amitript yline, appear consistently effective across the anxiety disorders. Selectiv e serotonin reuptake inhibitors (SSRIs) are particularly effective in panic disorder and obsessive-compulsive disorder. SSRIs are similar in efficacy to TCAs but are more tolerable and cause fewer serious adverse events. Howe ver, they are relatively slow to act, and efficacy data are limited in stat es such as generalized anxiety disorder. Newer antidepressants, such as mir tazapine, nefazodone, and venlafaxine XR, may provide some benefits across the broad spectrum of anxiety disorders with the safety and tolerability th at are the hallmarks of third generation antidepressants.