Nutt D
University of Bristol Psychopharmacology Unit, School of Medical Sciences, U.K.
J Clin Psychiatry. 1997;58 Suppl 8:11-6.
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.
当前的诊断分类将抑郁症与焦虑症区分开来，但在临床实践中，这些病症通常同时存在，在这两个极端之间形成了一系列的障碍。伴有焦虑症的抑郁症的治疗选择包括三环类抗抑郁药（TCAs）和5-羟色胺选择性再摄取抑制剂（SSRIs）。由于SSRIs不具有镇静作用，这证明TCAs产生的镇静作用并非抗焦虑作用所必需。SSRIs对焦虑症有效，且能对抗抑郁症患者的焦虑症状。SSRIs的不良事件谱优于TCAs，且在过量服用时更安全。当确诊伴有焦虑症的抑郁症时，鉴于存在自杀的潜在风险，及时开展有效治疗很重要。SSRIs似乎是这类患者的首选治疗药物。
