Management of mixed anxiety and depression

Anxiety and depression frequently coexist in the same patient. The physician should rule out secondary causes of the symptoms, assign a diagnostic category if possible and assess the relative severity and chronicity of primary symptoms and associated complaints. Supportive counseling is always indicated for these patients, and pharmacotherapy is often helpful as well. A number of therapeutic agents, including tricyclic antidepressants, azapirones and benzodiazepines, have been shown to be useful either alone or in combination. Careful monitoring of all symptoms and prudent adjustment of the medication regimen is imperative to ensure adequate resolution of symptoms.