The treatments of Anxious Depression

Kim, Hyeong Seob

Abstract

Anxiety symptoms and disorders frequently coexist in patients with major depression. Two conditions show extentive overlap with respect to symptomatology and a spectrum of disorders. The majority of patients were found to have mixed mixed anxiety-depressive syndrome(42.3%) or depression with comorbid anxiety(19.2%), with only 12.8% of the population having anxiety alone and 10.3% having depression alone. Moreover, the diagnosis of two disodders can be exchanged sometimes. Thus, anxiety and depression can not think over as a completely separate entities, especially for the treatment of two disorders. The presence of anxiety symptoms or disorders has been found to be associated with increased seveity and poorer outcomes of depression. including an increased risk of suicide, higher helplessness, poorer prognosis, more chronic course, more functional and psychosocial impairment. However, there is no confirmative pathogenesis for the anxious depression. Maybe it is supposed for the interactions of the neurotransmitters, especially serotonin and norepinephrine. All the antidepressants and anxiolytics can be used for the treatment of anxious depression, eventhough venalfaxine, mirtazapine & SSRIs were recommended for the first choice recently. However, TCAs and Benzodiazepines have some limits in the side of the adversive effects, addiction and the risk of suicide. Thu, benzodiazepines have to be used as a adjunctives or shortterm trial for the control of anxiety. Cognitive behavioral therapy is useful way to treat the anxious depression, however, it might be effective with pharmacotherapy. St. John's wort as a herbal medicine, rapide Transcranial Magnetic Stimulation(rTMS), Vagus Nerve Stimulation(VNS) will be applied in the future time.