Pharmacological therapies
Pharmacological treatment of depression, anxiety, and related disorders is an alternate or in some cases adjunct to psychological treatment. Drugs that influence glutamatergic, adrenergic, serotonergic, endocannabinoid systems and various neuropeptide are generally preferred. In such therapies antidepressants are the first-line pharmacological treatment options such as serotonin-noradrenaline reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs). These drugs are effective against several types of mental disorders specifically depression and anxiety (S28-S30). Agomelatine (a melatonin receptor agonist) and Vilazodone (a serotonin reuptake inhibitor and partial agonist of serotonin receptors) are also recommended in depression (S27,S31). Among second-line agents for anxiety and depressive disorders benzodiazepines have been found with good results. However, they have some serious adverse effects including dizziness, drowsiness, and increased risk of falls. In such cases the alternative drugs (that modulate GABA signaling), including, gabapentin and pregabalin can be used. In case of severe anxiety, risperidone or quetiapine (atypical antipsychotics) should be given as an adjunct to SSRIs or SNRIs (S27,S31-S33). All these drugs could be effective; however, their use should be only recommended when psychological approaches are not working. Nevertheless, the use of both pharmacotherapy and psychotherapy (combined therapy) is more beneficial and effective in the case of chronic anxiety and depressive disorders (S27).