Antidepressants plus benzodiazepines in major depressive disorder: a clinical dilemma with no recent answers from research.

Abstract

Comorbid anxiety symptoms are common in depression, and adding benzodiazepines to antidepressant treatment may seem a rational clinical solution. They also have potential to reduce the initial anxiety that may be caused by early antidepressant treatment due to their inhibitory effect via GABA-A receptor binding. This month's Cochrane Corner review examines the evidence behind combination treatment versus antidepressants alone in major depressive disorder, both in terms of 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 in terms of ratings of severity, response rates and remission rates, but not for measures of anxiety.