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Anxiety and Stress Disorders

Using SSRI for GAD and Depression

03/27/2006

Question:

I read in recently anwered question that the anxiety disorders occur when brain cells and their neurotransmitters (chemicals that the brain uses to communicate) get out of balance. Outside experiences and behaviors can both exacerbate or improve the anxiety.

My question is whether chemical imbalance or deficit as we call it indicate depression/panic disorder? Whenever, one apporoaches the psychiatrist with issue of anxiety disorder, stress, the tablet like Zoloft or lexapro or paxil is prescribed. Does it indicate that anxiety disorder equate to depression or bear any resemblance. You will appreciate that in society like ours, if you say you are on treatment for anxiety disorder, it will have one impact and moment one says that he is on treatment of depression, the impression of the other person will change. Point is does depression and anxiety are different ? If yes,then why SSRI is common for both the disorder ?

Answer:

Both anxiety disorders and depression share common pathways in brain biochemistry.  There are similar findings in new studies using technology such as functional MRIs (which show areas of the brain that are working, or not working, properly under certain conditions) and measuring chemical neurotransmitters.  There are also many large studies of populations of people that show a large overlap between those who have anxiety and those who have depression -- in other words many people suffer from both anxiety and depression (or their anxiety has some components of depression in it or they have an anxious type of depression.

Selective serotonin reuptake inhibitors are considered first line medications for both anxiety and depression.  If you have been diagnosed with anxiety, and your doctor recommends an SSRI, it is not that your doctor also thinks you have depression, or is treating you incorrectly 00 the SSRIs work very well for depression, although patients with anxiety may need to take higher doses and for a longer period of time before they see results than do people with depression.

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Response by:

Nancy Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati