LEADING ART ICLE ~~--------------------------
Drugs 44 (2): 165-169, 1992 00 12-6667/92/0008-0165/$02.50/0 © Adis In.ternationa1 Limited. All rights reserved. DRUl172
Benzodiazepines
Depressants or Antidepressants?
John w.G. Tiller and Isaac Schweitzer Department of Psychiatry, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Berizodiazepines have been linked with depression and, conversely, it has been said that they may relieve symptoms of depression. This article considers some of the issues regarding benzodiazepines .and depression.
1. Do You Get Anxiety with Depression, or Depression with Anxiety? In fact both occur. This makes it difficult in trying to identify whether a psychoactive agent iri~ duces depression or not. The DSM-III-R (1987) diagnostic criteria for a major depressive episode include insomnia, psychomotor agitation, loss of energy, diminished ability to think or concentrate, and indecisiveness, andirrilable mood in children and adolescents. These may be seen as having anxiety-like qualities. In contrast, diagnostic criteria for generalised anxiety include muscle tension, aching and soreness, easy fatiguability, difficulty concentrating, mind going blank, trouble fallingor staying asleep, and irritability - .depression-Iike symptoms. Thus, there are symptoms typically associated with anxiety in depressive disorders and with depression in anxiety disorders. More importantly, longitudinal studies of patients with panic disorder show a high prevalence of depression. Klerman (1988) reported that comorbidity with depression is high among patients with panic disorder and agoraphobia. Estimates as high as 40 to 50% have been reported in treatment settings by Sheehan et al. (1981).
Anxiety and depression are often seen and treated as 2 separate entities, with their comorbidity not rec9gnised, It is alsd,!mportant to realise that confusion may arise froml" statements that .. benzodiazepines are central nery,pus system (CNS) depressants. This re~ fer~ to .de~r~ssed CNS functioning and not to the iriductio~ ~lhi'this context) of a depressed mood, or depressi~~ ! illness. Benzodiazepines are cortical : I ,"
Drugs 44 (2): 165-169, 1992 00 12-6667/92/0008-0165/$02.50/0 © Adis In.ternationa1 Limited. All rights reserved. DRUl172
Benzodiazepines
Depressants or Antidepressants?
John w.G. Tiller and Isaac Schweitzer Department of Psychiatry, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
Berizodiazepines have been linked with depression and, conversely, it has been said that they may relieve symptoms of depression. This article considers some of the issues regarding benzodiazepines .and depression.
1. Do You Get Anxiety with Depression, or Depression with Anxiety? In fact both occur. This makes it difficult in trying to identify whether a psychoactive agent iri~ duces depression or not. The DSM-III-R (1987) diagnostic criteria for a major depressive episode include insomnia, psychomotor agitation, loss of energy, diminished ability to think or concentrate, and indecisiveness, andirrilable mood in children and adolescents. These may be seen as having anxiety-like qualities. In contrast, diagnostic criteria for generalised anxiety include muscle tension, aching and soreness, easy fatiguability, difficulty concentrating, mind going blank, trouble fallingor staying asleep, and irritability - .depression-Iike symptoms. Thus, there are symptoms typically associated with anxiety in depressive disorders and with depression in anxiety disorders. More importantly, longitudinal studies of patients with panic disorder show a high prevalence of depression. Klerman (1988) reported that comorbidity with depression is high among patients with panic disorder and agoraphobia. Estimates as high as 40 to 50% have been reported in treatment settings by Sheehan et al. (1981).
Anxiety and depression are often seen and treated as 2 separate entities, with their comorbidity not rec9gnised, It is alsd,!mportant to realise that confusion may arise froml" statements that .. benzodiazepines are central nery,pus system (CNS) depressants. This re~ fer~ to .de~r~ssed CNS functioning and not to the iriductio~ ~lhi'this context) of a depressed mood, or depressi~~ ! illness. Benzodiazepines are cortical : I ,"
