oa SA Pharmaceutical Journal - Examining the relationship between anxiety disorders and depression : clinical

Volume 73, Issue 6
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017



Depression and anxiety commonly occur together as symptoms or syndromes. <br>The lifetime prevalence of any anxiety disorder is 1 in 4 and of major depressive disorder 1 in 6. <br>Anxiety and depression may selectively distort cognitions and perceptions to fit the particular affect. <br>Common medical causes for anxiety and depression include hypoxia, epilepsy, amphetamines/ cocaine/alcohol. <br>The amygdala mediates stress and fear responses, with the locus coeruleus/raphe nuclei mediating anxiety. <br>Limbic system, basal ganglia and hypothalamic dysfunction occurs across the anxiety and depressive disorders. <br>In anxiety and depressive disorders, there is blunted cortisol response to ACTH, blunted GH response to clonidine, blunted TSH and prolactin responses to TRH, and noradrenergic system hyperactivity. <br>In general, MDD is co-morbid with all anxiety disorders. <br>Antidepressants (especially SSRIs) are also effective anxiolytics at higher doses. <br>CBT is effective in mild to moderate major depression and in most anxiety disorders, and produces less relapse on cessation compared with pharmacotherapy.

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