By the clinical team at Next Step Psychiatry • Lilburn, GA
Anxiety and depression frequently occur together—roughly 60% of people with anxiety also experience symptoms of depression. The good news? Many medications effectively treat both conditions simultaneously. At Next Step Psychiatry, our board-certified psychiatrists help patients across Atlanta and Gwinnett County find the right medication with minimal trial and error.
SSRIs: The First-Line Choice
Selective serotonin reuptake inhibitors (SSRIs) remain the gold standard for treating co-occurring anxiety and depression. They work by increasing serotonin levels in the brain, improving mood and reducing anxious thoughts. Common SSRIs include sertraline (Zoloft), escitalopram (Lexapro), fluoxetine (Prozac), and paroxetine (Paxil). Most patients tolerate SSRIs well, with side effects like nausea and headache typically fading within the first two weeks.
SNRIs: When SSRIs Aren't Enough
Serotonin-norepinephrine reuptake inhibitors (SNRIs) target two neurotransmitters instead of one. Venlafaxine (Effexor) and duloxetine (Cymbalta) are particularly effective for generalized anxiety disorder combined with major depression. SNRIs may also help with chronic pain, which frequently accompanies mood disorders.
Bupropion: The Energizing Option
Bupropion (Wellbutrin) works differently—it affects dopamine and norepinephrine rather than serotonin. It's an excellent choice for patients with depression who also experience fatigue, low motivation, or concerns about sexual side effects and weight gain. However, bupropion can sometimes increase anxiety, so your psychiatrist will assess whether it's appropriate for your specific symptoms.
Buspirone: An Anxiety-Specific Add-On
Unlike benzodiazepines, buspirone is non-addictive and can be combined with antidepressants to specifically target anxiety symptoms. It takes 2–4 weeks to reach full effect but is well-tolerated and safe for long-term use.
What About Benzodiazepines?
Medications like Xanax (alprazolam) and Klonopin (clonazepam) provide rapid anxiety relief but carry significant risks: dependence, tolerance, and withdrawal symptoms. At Next Step Psychiatry, we use benzodiazepines sparingly and only as short-term bridges while longer-acting medications take effect.
For Treatment-Resistant Cases
When two or more medications haven't worked, you may have treatment-resistant depression. Spravato (esketamine) is an FDA-approved nasal spray that works through a completely different mechanism—targeting NMDA receptors. As a REMS-certified Spravato center, we've seen patients experience relief within 24–48 hours after years of struggling.
How We Help You Find the Right Medication
There is no single “best” medication—the right choice depends on your symptom profile, medical history, other medications, and personal preferences. At Next Step Psychiatry, Dr. Aneel Ursani and Fathima Chowdhury, PA-C take the time to understand your complete picture before recommending a treatment plan. We offer same-day appointments and telepsychiatry throughout Georgia.
Call 678-437-1659 to schedule your appointment.
This article is for informational purposes only and is not a substitute for professional medical advice. If you or someone you know is in crisis, call 911 or the 988 Suicide & Crisis Lifeline.