Sussman N
Department of Psychiatry, New York University School of Medicine, New York.
J Clin Psychiatry. 1993 May;54 Suppl:8-16; discussion 17-20.
According to the official nomenclature and the approved indications for psychotropic drugs, anxiety and depression are mutually exclusive, and antidepressants and anxiolytics have a single indication. In clinical settings, however, anxiety and depressive symptoms frequently coexist, and the effects of psychotropic drugs often overlap. Both diagnosis and treatment may be complicated by uncertainty about the primary disorder and the optional therapeutic approach. Available treatment strategies include antidepressants, benzodiazepines, azapirones, and combined antidepressant/anxiolytic therapy. Considerations in reflecting a particular treatment strategy include drug side effects, patient age and medical status, and patient expectations. Recent studies have suggested that antidepressants are effective anxiolytics and that some anxiolytics produce antidepressant effects. Ultimately, any selection should be made based on relative benefits and risks of each approach.
根据精神药物的官方命名法和批准的适应症，焦虑症和抑郁症是相互排斥的，抗抑郁药和抗焦虑药都只有单一适应症。然而，在临床环境中，焦虑和抑郁症状常常并存，精神药物的作用也常常重叠。原发性疾病和可选治疗方法的不确定性可能会使诊断和治疗变得复杂。现有的治疗策略包括使用抗抑郁药、苯二氮䓬类药物、阿扎哌隆类药物以及联合使用抗抑郁/抗焦虑疗法。选择特定治疗策略时需要考虑的因素包括药物副作用、患者年龄和健康状况以及患者期望。最近的研究表明，抗抑郁药是有效的抗焦虑药，一些抗焦虑药也会产生抗抑郁作用。最终，任何选择都应基于每种方法的相对益处和风险来做出。
