Although tricyclic antidepressants are considered the treatment of choice in major depression, patients more often receive benzodiazepines than tricyclic antidepressants.

All studies, comparing the efficacy in depression of benzodiazepines versus placebo, tricyclics or both, are reviewed.

The use of benzodiazepines as monotherapy in depression is not supported, however benzodiazepines can be useful in combination with tricyclic antidepressants, especially during the first weeks of treatment. Until now a specific other place for alprazolam in major depression has not been demonstrated.