Depression & anxiety in the primary care setting.

Depression and anxiety disorders are common in primary care. Diagnosis is accomplished by applying of specific, data-driven diagnostic criteria published in the DSM-IV. The differential diagnosis is sometimes difficult, but as a general rule the treatment of choice for both conditions is antidepressant medicine. It is very important to remember that anxiety disorders respond very nicely to most antidepressants, but depression does not respond to tranquilizers. BZs, should be reserved for adjunctive use in the early stages of treatment for both anxiety disorders and depression. The azapirone, buspirone, may be used as first line treatment for generalized anxiety disorder and may also augment antidepressants when the patient presents with mixed anxiety and depression. The important point is that when in doubt about either the diagnosis or which drug to choose first it is generally safe to select one of the newer antidepressants discussed in this article.