Treatments for comorbid anxiety and mood disorders

Anxiety disorders (such as generalized anxiety disorder) are highly comorbid with depression, and the polyvalent effects from herbal medicines can potentially target a range of symptoms that commonly overlap in these disorders. Herbal medicines with mood-elevating effects may also have anxiolytic effects. This may be due to modulation of neurological pathways that have both antidepressant and anxiolytic effects (in particular, the GABA and serotonin systems), or this may be due to anxiety being reduced when depression is adequately treated. For example, this effect was found in the case of a recent double-blind, randomized controlled trial (RCT) involving participants with generalized anxiety, which found that while Piper methysticum (kava) significantly reduced participants’ anxiety beyond placebo, this also occurred for their depression levels. Various nutraceuticals have been shown to provide antidepressant activity, with several having notable antidepressant effects: Hypericum perforatum (St John’s wort), Crocus sativus (saffron), omega-3 fatty acids, S-adenosyl methionine (SAMe), and zinc. These may have a prescriptive role in treating depression co-occurring with anxiety, though it should be noted that none of these agents have been shown to have primary anxiolytic effects