Management of patients with depression associated with anxiety symptoms.

Current diagnostic classifications separate depression from anxiety, yet these conditions commonly coexist in clinical practice, forming a spectrum of disorders between these extremes. Treatment options for depression with anxiety include tricyclic antidepressants (TCAs) and serotonin selective reuptake inhibitors (SSRIs). As SSRIs are nonsedating, this proves that sedation as produced by TCAs is not required for anxiolytic actions. SSRIs are effective in anxiety disorders and against anxiety symptoms in depressed patients. The adverse event profile of SSRIs compares favorably with that of TCAs, and SSRIs are much safer in overdose. When the diagnosis of depression with anxiety is established, it is important to institute prompt, effective treatment in view of the potential risk of suicide. The SSRIs appear to be the treatment of choice for such patients.