Anxiety and Depression Comorbidity: Implications and Intervention

Naomi M. Simon, MD; Jerrold F. Rosenbaum, MD


March 27, 2003

In This Article


The presence of major depression should trigger careful screening for anxiety disorders, and vice versa. The presence of comorbidity is associated with greater severity, higher suicidality, and poorer response to treatment. Antidepressants, particularly SSRIs and the SNRIs, are first-line pharmacotherapy for depression and anxiety disorders. However, antidepressants should be initiated at lower doses and slowly titrated to clinical efficacy to improve tolerability in the presence of anxiety comorbidity. The presence of depression comorbidity should direct treatment away from monotherapy with benzodiazepines. More research is needed to better elucidate the relationship of anxiety disorders and symptoms with depression, and the impact of specific comorbidities on treatment selection and outcomes.


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