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Treatment Considerations for Anxiety in the Elderly

Published online by Cambridge University Press:  07 November 2014

Eric J. Lenze,
Bruce G. Pollock,
M. Katherine Shear,
Benoit H. Mulsant,
Ashok Bharucha and
Charles F. Reynolds III
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Abstract

Anxiety is common in the elderly and can present as a primary anxiety disorder or as a symptom of another disorder. Generalized anxiety disorder, in particular, is a common syndrome in late life. Anxiety symptoms are also common features of late-life depression and dementia. Treatment of anxiety in elderly persons has typically involved the use of benzodiazepines, which are often effective but problematic because they are associated with increased risk of cognitive impairment, falls, and fractures. Based on their safety and efficacy, antidepressants, particularly serotonergic medications, are considered first-line treatment for most anxiety disorders as well as anxiety symptoms of major depressive disorder. Psychotherapy, particularly cognitive-behavioral therapy, may be effective in these disorders as well; research is underway to adapt this therapy to the needs of elderly persons. Anxiety symptoms in dementia are poorly understood but may respond to atypical antipsychotics, serotonergic antidepressants, or mood stabilizers. Overall, the research in late-life anxiety has not caught up to the literature in late-life depression and, for the most part, treatment recommendations must be extrapolated from studies in young adults.

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Type
Academic Supplement
Information
CNS Spectrums , Volume 8 , Issue S3: Anxiety and Depression in the Elderly: Implications for Diagnosis and Treatment , December 2003, pp. 6 - 13
Copyright
Copyright © Cambridge University Press 2003

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