LAUSR

Major depressive disorder (MDD) associated with either high levels of anxiety or a comorbid anxiety disorder presents a challenge for treatment. There is substantial evidence that in these patients there is an elevated rate of poor response to treatment, increased rates of treatment resistance and a raised rate of suicidal risk (Souery et al., 2007; Fava et al., 2008). The usual advice given for the treatment of this group is to augment treatment with an antidepressant by the addition of an anxiolytic. Most frequently, a benzodiazepine is used despite their well known associated problems and the lack of evidence in support of extra benefit.