advertisement
Home » News » Medication May Help Senior Anxiety

Medication May Help Senior Anxiety

Medication May Help Senior AnxietyPreliminary research suggests that use of the drug escitalopram (known by its brand name Lexapro) provided some improvement in symptoms for older adults with generalized anxiety disorder.

Generalized anxiety disorder (GAD), one of the most common psychiatric disorders in older adults, is defined by chronic, difficult-to-control worry and anxiety, with related symptoms such as muscle tension, sleep disturbance and fatigue.

The prevalence of GAD is as high as 7.3 percent among community-dwelling older adults and even higher among primary care patients. Because the number of older adults in the U.S. is growing and there is a lack of effective treatment, GAD in older adults will become an increasing human and economic burden, according to background information in the article.

Selective serotonin reuptake inhibitors (SSRIs) are effective for younger adults with GAD, but little data exist regarding the outcomes of their use by older adults.

Although the overall findings were positive, study authors note that the absolute benefits were diminished because of nonadherence to the drug by some patients.

The study is found in the January 21 issue of JAMA.

Eric J. Lenze, M.D., of Washington University, St. Louis, and colleagues examined the effectiveness, safety, and tolerability of the SSRI escitalopram for the treatment of GAD in older adults.

The study included 177 participants age 60 years or older with a diagnosis of GAD, who were randomized to receive either 10 to 20 mg/d of escitalopram (n = 85) or matching placebo (n = 92) for 12 weeks. Anxiety and other outcomes were measured using a number of assessment tools.

The researchers found that the cumulative incidence of response to treatment was higher in the escitalopram group than in the placebo group (69 percent vs. 51 percent). Participants treated with escitalopram showed greater improvement than with placebo in anxiety symptoms and role functioning, activity limitations and impairments in role and social functioning.

In the intention-to-treat (ITT) analysis, which included those who began the trial but may have dropped out, the response was not different between groups. Of the participants who received escitalopram, 16 (18.5 percent) dropped out of the study before week 12; of the participants who received placebo, 17 (18.4 percent) dropped out before week 12.

Adverse effects of escitalopram were fatigue or sleepiness, sleep disturbance and urinary symptoms.

“The lack of efficacy of escitalopram in the ITT analysis is consistent with its overall modest efficacy, diminished further by nonadherence. Given that patients with anxiety disorders are often poorly adherent to pharmacotherapy, these negative results may more accurately portray the results of treatment in clinical settings,” the authors write.

“It is important for clinicians to emphasize to their anxious older patients the need for an adequate trial in which to observe any benefits, as well as the expectation and nature of adverse effects. Given the high human and economic burden of GAD, these data should provide impetus to detect and treat this common disorder.

“Further study is required to assess efficacy and safety over longer treatment durations.”

Source: JAMA and Archives Journals

Medication May Help Senior Anxiety

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Medication May Help Senior Anxiety. Psych Central. Retrieved on October 22, 2018, from https://psychcentral.com/news/2009/01/21/medication-may-help-senior-anxiety/3676.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.