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Adjunctive benzodiazepines in depression: a clinical dilemma with no recent answers from research

Published online by Cambridge University Press:  30 October 2020

Angharad N. de Cates*
Affiliation:
Wellcome Trust Doctoral Training Fellow in the Department of Psychiatry, University of Oxford, and an Honorary Specialist Registrar with Oxford Health NHS Foundation Trust, UK. She is also the RCPsych Neuroscience Champion for the West Midlands.
Riccardo De Giorgi
Affiliation:
Wellcome Trust Doctoral Training Fellow in the Department of Psychiatry, University of Oxford, and an Honorary MRCPsych Clinical Fellow with Oxford Health NHS Foundation Trust, UK. Both authors work on experimental medicine studies for mood disorders and have interests including the evidence-based treatment of mental illness and the neuroscientific underpinnings of psychopharmacology.
*
Correspondence Angharad N. de Cates. Email: angharad.decates@psych.ox.ac.uk

Summary

Comorbid anxiety symptoms are common in depression, and adding benzodiazepines to antidepressant treatment may seem a rational clinical solution. Benzodiazepines also have potential to reduce the initial anxiety that may be caused by early antidepressant treatment (owing to their inhibitory effect via GABAA receptor binding). This month's Cochrane Corner review examines the evidence behind combination treatment versus antidepressants alone in major depressive disorder, in terms of both the clinical and neuroscientific context. The review provides evidence that, in the first 4 weeks of treatment, additional medication with a benzodiazepine may lead to greater improvements than antidepressant alone on ratings of severity, response rates and remission rates for depression, but not on measures of anxiety.

Type
Round the corner
Copyright
Copyright © The Authors 2020

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Footnotes

Commentary on… Antidepressants plus benzodiazepines for adults with major depression: a Cochrane Review. See this issue.

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