Can Antidepressants and Anxiolytics Be Combined?

Have you been prescribed antidepressants and anxiolytics to treat depression? Do you want to know if there's any risk when consuming these two drugs together? You can solve any doubts you might have by reading this article.

Written and verified by the psychologist Valeria Sabater.

Last update: 19 May, 2023

Many patients wonder if it’s safe to combine antidepressants and anxiolytics. Under certain conditions, the answer is yes. In fact, a combination of the two is a common strategy for treating depression. This psychopharmacological approach is frequent when the patient also exhibits anxiety.

Indeed, patients with low energy, appetite disturbances, feelings of hopelessness, and anxious thoughts benefit significantly from this combination. However, the best results always appear when they combine psychological therapy with the use of these medications.

How antidepressants and anxiolytics can be helpful

Antidepressants and anxiolytics are frequently used in the treatment of depression. Research conducted by the Hôpital St-Antoine in Paris confirms that anxiety frequently coexists alongside depression. For this reason, physicians often also prescribe anxiolytics.

We’re going to briefly analyze the two kinds of antidepressants and anxiolytics that are currently the most prescribed in the world. They’re considered to be safe and are endorsed by the relevant medical organizations. Moreover, when correctly taken, they don’t cause addiction. Their side effects are also quite manageable.

Antidepressants

Antidepressants are prescribed to treat mood disorders (anxiety and depression) and to address chronic pain. Currently, the most commonly prescribed are selective serotonin reuptake inhibitors (SSRIs). For example, fluoxetine and sertraline.

These drugs take several weeks to take effect. Furthermore, patients should only take them for a limited time. They also shouldn’t ever skip tablets and withdrawal should always be gradual. However, not everyone benefits from them. Consequently, there’s a small percentage of the population that requires other resources.

Anxiolytics

Anxiolytics treat anxiety disorders and sleep problems. They influence the central nervous system, more specifically, gamma-aminobutyric acid (GABA), generating an inhibitory action. This reduces the activity of the central nervous system and produces feelings of calm and relaxation.

Anxyiolotics provide sedative and anticonvulsant effects. The most commonly used are benzodiazepines. For instance, diazepam, lorazepam, and alprazolam.

These drugs are effective in reducing anxiety symptoms and helping the patient sleep. On the other hand, they can have side effects such as drowsiness, dizziness, confusion, and short-term memory problems. Due to the fact that they can cause dependence, they should be used with caution and under supervision.

Combining antidepressants and anxiolytics: purpose, effectiveness, and associated effects

The coexistence of depression with anxiety disorders is common. For this reason, it’s possible to combine antidepressants and anxiolytics. This is a safe and recommended practice in the medical community. In fact, it’s particularly useful since, in recent years, the cases of patients exhibiting major depression alongside anxiety symptoms have increased considerably.

Research conducted by Emory University (USA) highlights that these two conditions often appear as subsyndromal symptoms. This means that the patient may not meet all the criteria for a clear diagnosis of depression and/or anxiety to be made. Instead, a combination of both clinical disorders appears.

Is the treatment effective?

In 2004, the Journal of Psychiatry and Neuroscience published a study on the concomitant use of both drugs. It claimed that combining antidepressants and anxiolytics are safe and useful in the first weeks of treatment and achieves rapid improvement. If the patient also carries out adequate psychological therapy, the effects will be even more positive. Moreover, they avoid relapses.

We know that anxiolytics or benzodiazepines increase the effectiveness of antidepressants. But, after a few weeks, it’s advisable to gradually withdraw the former. Indeed, long-term or permanent treatments of these two drugs are best avoided if possible.

The associated side effects

Combining antidepressants and anxiolytics for one, four, or six months has mild and generally tolerable side effects. They’re as follows:

• Dizziness.
• Fatigue.
• Drowsiness.
• Constipation.
• Possible nausea.
• Changes in appetite.
• The sensation of dry mouth.
• Slowing of reaction times.
• Possible decreased sexual desire.

If a patient takes these psychoactive drugs for a prolonged period they may experience other slightly more severe symptoms. As a rule, they manifest as follows:

• Chronic fatigue.
• Weight gain.
• Sexual problems.
• Sleep disorders.
• Digestive problems.
• Changes in menstruation.
• Feelings of dependence.
• Possible cardiac alterations, such as tachycardia.
• Mood swings and an increased tendency toward depression.
• Cognitive difficulties. For example, difficulty in focusing attention, small memory lapses, etc.

Warnings when taking antidepressants and anxiolytics together

A combination of antidepressants and anxiolytics is beneficial because benzodiazepines potentiate the effect of drugs such as fluoxetine or sertraline. This clinical strategy is safe and useful. But, psychotropic drugs, although they help, don’t put a stop to the disorder by themselves. As such, they don’t permanently restore autonomy to the patient.

In fact, psychological therapy is the best mechanism for addressing a depressive disorder with anxiety comorbidities. The cognitive-behavioral approach and acceptance and commitment therapy (ACT) are both helpful. Mixing these therapies with drugs -if the doctor considers it appropriate- can be extremely effective.

Finally, we must emphasize the need to always follow the advice of specialists if you’re taking anxiolytics and antidepressants. Don’t skip tablets and, in the event of any unexpected side effects, don’t hesitate to consult your doctor. They can always prescribe alternatives.