MoodRx Clinical Staff - Oct 15, 2024
27 medications that may improve depression and anxiety symptoms
Depression and anxiety are both mental health conditions that can come with significant physical symptoms. Along with low moods, worry and fear, people with both conditions may experience fatigue, tension, muscle aches, sleep disturbances, indigestion and other types of discomfort. As these are two of the most common mental health conditions, they often overlap. The first-line treatment for co-occurring anxiety and depression is a combination of therapy and medication. People with both conditions may have a harder time finding effective treatment. However, that means it’s especially important that they self-advocate and work with their care providers to find a treatment regimen that works for them.
Co-occurring anxiety and depression are common, though the complex relationship between them is still being explored. Research shows that 40% to 50% of people with either depression or an anxiety disorder have symptoms of both. Depending on an individual client’s symptom presentation, there are several different diagnoses that can explain the presence of both anxiety and depression. People with conditions like post-traumatic stress disorder (PTSD) and bipolar disorder may have symptoms of both depression and anxiety. The category of mixed anxiety and depression appeared in the DSM-IV, but it has since been removed because the criteria weren’t consistently reliable. The DSM-5-TR includes a specifier for anxious distress with major depressive disorder (MDD).
In this blog post, we’ll discuss different types of medications that may improve depression and anxiety symptoms.
What medications help with both depression and anxiety?
A few different classes of antidepressants can treat both anxiety and depression. Tricyclic antidepressants (TCAs) are an older type of depression medication. While they’re effective at treating both depression and anxiety, they come with a higher risk of side effects and overdose. Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants mirtazapine and nefazodone have shown promising results for the treatment of co-occurring anxiety and depression.
Combining two different types of medication can be more effective than prescribing a single antidepressant. Antidepressants can be combined with an antidepressant from a different class, an anti-anxiety medication like a benzodiazepine (BZD) or buspirone, a neuroleptic agent, or lithium. Traditional anti-anxiety medications aren’t effective for treating depression, so an antidepressant will usually be necessary. In some cases, a prescriber may start with medications for both conditions and then taper the anxiety medication as symptoms decrease.
Selective serotonin reuptake inhibitors
SSRIs work by slowing the brain’s reuptake of serotonin, a neurotransmitter that plays a role in mood, sleep quality, digestion and other body functions. People with anxiety and depression don’t have as much serotonin. When more of it is available in the brain, you feel happier and less stressed. Most side effects of SSRIs are mild. However, serotonin syndrome is a rare condition that people taking SSRIs should be aware of. Symptoms include being nervous or jittery, high fever, sweating, confusion, shaking, lack of coordination, changes in blood pressure, and a rapid heartbeat.
The following are some SSRIs that can treat both anxiety and depression:
- Fluoxetine
- Sertraline
- Paroxetine
- Fluvoxamine
- Citalopram
- Escitalopram
- Vilazodone
SSRIs can cause the following side effects:
● Shakiness
● Dry mouth
● Headache
● Sweating
● Nervousness or restlessness
● Upset stomach, vomiting or diarrhea
● Drowsiness or trouble sleeping
● Sexual dysfunction
● Changes in appetite
Serotonin-norepinephrine reuptake inhibitors
SNRIs are like SSRIs, but they affect both serotonin and norepinephrine. Norepinephrine helps regulate arousal, attention, cognitive function and stress reactions. SNRIs come with a similar profile of potential side effects.
The following are some SNRIs that can treat both anxiety and depression:
- Venlafaxine
- Desvenlafaxine
- Duloxetine
- Milnacipran
- Levomilnacipran
Tricyclic antidepressants
TCAs are an older form of depression medication that may also be prescribed for anxiety. Because of the increased risk of side effects, doctors may try other medications before prescribing TCAs.
These are some examples of TCAs that can treat both anxiety and depression:
- Amitriptyline
- Imipramine
- Nortriptyline
In addition to side effects that are common with SSRIs and SNRIs, people who take TCAs may experience the following:
● Blurred vision
● Constipation
● Drop in blood pressure and lightheadedness when moving from sitting to standing
● Problems passing urine
● Disorientation or confusion, especially in older people on high doses
● Irregular or fast heartbeat
● Seizures, for people who have had them before
Atypical medications
Newer medications have been developed that work differently than recent generations of anxiety and depression medications. Mirtazapine and nefazodone can both be effective treatments for anxiety and depression. Other atypical antidepressants, such as bupropion, would need to be combined with an anti-anxiety medication. Buspirone is an anti-anxiety medication that’s generally safer than others, and it can be used to treat depression. Gabapentin is a medication for seizures and nerve pain that can also treat anxiety. Each of these medications has a unique list of potential side effects.
The following are some atypical antidepressants that doctors may prescribe for people with depression and anxiety:
- Mirtazapine
- Nefazodone
- Trazodone
- Vilazodone
- Vortioxetine
- Bupropion
- Buspirone
- Gabapentin
Benzodiazepines
BZDs cause the brain to release more gamma-aminobutyric acid (GABA), making the nervous system less active. They can be used to treat anxiety as well as seizures, insomnia and muscle spasms.
BZDs are habit forming, and they can have dangerous effects when misused or combined with other medications and substances. They shouldn’t be taken with opioid pain medications or alcohol. Fortunately, there’s an antidote that reverses the effects of BZDs called flumazenil.
The following are examples of benzodiazepines:
- Alprazolam
- Eszopiclone
- Zaleplon
- Zolpidem
Some potential side effects of benzodiazepines include:
● Slowed or stopped breathing
● Drowsiness
● Confusion
● Headache
● Fainting
● Nausea and vomiting
● Diarrhea
● Shaking
Other treatments to combine with anxiety and depression medication
Medication for anxiety and depression is most effective when it’s combined with therapy. People with these conditions should take care to eat a balanced diet, get eight to nine hours of sleep per night, and exercise regularly. Staying physically healthy can reduce both the physical and mental impact of anxiety and depression. You can also learn mindfulness practices and breathing exercises; these can help you manage your stress and calm down when your symptoms are triggered. Certain supplements can help with anxiety and depression, such as omega-3 fatty acids, vitamin D and ashwagandha. You should talk with your prescriber before adding any supplements to your health regimen.
People with both anxiety and depression will see the best results when they work with a therapist who has experience treating both conditions. Finding a therapist you like can be difficult, especially at times when you need the most help. We created the MoodRx Therapy Network to simplify the process. Our platform makes it easy to monitor your mental health, match with the right therapist and manage your care. All of our therapists meet with clients online so you can make treatments work with your schedule.
Do you have questions about seeking treatment for anxiety and depression? Contact our team today for more information or to sign up for free. Let’s talk about your next steps toward a more fulfilling life.
