[Current drug treatment. Effects of antidepressive agents in nervous and stress-related disorders]

Antidepressants have a much broader range of indication than the name suggests. The efficacy of antidepressant treatment of nervous and stress-related disorders has been documented in several controlled trials, both in comparison with placebo and with other antidepressants. Most studies have included testing in panic disorder, with or without agoraphobia, and obsessive compulsive disorder, but there is empirical evidence for the efficacy of the drugs in most anxiety disorders. Antidepressants with a preference for serotonergic neurotransmission (i.e. clomipramine and SSRIs (serotonin specific reuptake inhibitors) are particularly effective in the treatment of panic disorder and obsessive compulsive disorder. Owing to their more favourable side effect profile as compared with classical antidepressants, the SSRIs are considered to be the drugs of first choice, except for generalised anxiety disorder, where the efficacy of venlafaxine has been most thoroughly documented. Studies comparing different antidepressant are warranted. So are studies elucidating the relative benefits of drug treatment and psychotherapy, but, with the concept of modern anxiety treatment, there is no principal objection to combining the two treatment methods.