Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X
Issue: 2013, vol. 19, book 1;
Subject Collection: Medicine
Published online: 28 June 2013
J of IMAB. 2013; 19(1):420-422;
SOME PHARMACOLOGIC TREATMENT OPTIONS IN LATER- LIFE ANXIETY DISORDERS
Third Psychiatric Clinic, UMHAT "St. Marina", Department of Psychiatry, Medical University of Varna, Bulgaria.
Most recommendations for treatment of anxiety in later life are based on evidence, derived from studies of younger populations. An important challenge is the high psychic and physical comorbidity of primary anxiety disorders.
The aim of our study was to examine the pharmacological treatment of elderly patients in acute psychiatry setting, presenting with anxiety disorder.
All subjects underwent clinical psychiatric examination and evaluation according to ICD-10 and DSM-IV criteria for an anxiety disorder and depression. The patients were examined also for a physical comorbidity.
Depressive-anxious or comorbid with depression anxious patients prevailed. Primary solitary anxiety disorders were less seen. High physical comorbidity was registerd.
Pharmacologic treatment consisted mostly of benzodiazepines and antidepressants. A considerable number of patients received Quetiapine in their therapeutic plans.
Pharmacologic treatment in elderly patients with anxiety disorders should be precisely administered. Standard pharmacotherapy of anxiety disorders for a number of elderly patients needs to be modified. Further research is needed to determine the most appropriate safe and effective treatment model.
Key words: anxiety, later life, elderly, therapy.
- Download FULL TEXT /PDF 700 KB/
Please cite this article as:
Arnaudova M. Some pharmacologic treatment options in later- life anxiety disorders. J of IMAB. 2013; 19(1):420-422. DOI: 10.5272/jimab.2013191.420.
Correspondence to: Mariana Arnaudova-Jekova, MD, PhD; Third Psychiatric Clinic UMHAT "St. Marina"; 1, Hristo Smirnenski str, 9010 Varna, Bulgaria
1. Boulenger J, Capdevielle D. Pharmacological treatment of generalized anxiety disorders: rationale and limitations. [in French] Encephale. 2007 Jan-Feb; 33(1):84-94. [PubMed]
2. Schoevers RA, Beekman AT, Deeg DJ, Jonker C, van Tilburg W. Comorbidity and risk-patterns of depression, generalised anxiety disorder and mixed anxiety-depression in later life: results from the AMSTEL study. Int J Geriatr Psychiatry. 2003 Nov;18(11): 994-1001 [PubMed] [CrossRef]
3. Byers AL, Yaffe K, Covinsky KE, Friedman MB, Bruce ML. High Occurence of Mood and Anxiety Dsorders Among Older Adults. Arch Gen Psychiatry. 2010 May;67(5):489-496. [PubMed] [CrossRef]
4. Baldwin DS, Ajel KI, Garner M. Pharmacological treatment of generalized anxiety disorder. Curr Top Behav Neurosci. 2010; 2:453-67. [PubMed]
5. Diefenbach GJ, Goethe J. Clinical Interventions for Late-Life Anxious Depression. Clin Interv Aging.2006 Mar; 1(1):41-50. [PubMed]
6. Keene MS, Eaddy MT, Nelson WW, Sarnes MW. Adherence to Paroxetine CR compared with Paroxetine IR in a Medicare-eligible population with anxiety disorders. Am J Manag Care. 2005 Oct;11(12 Suppl):S362-369. [PubMed]
7. Mitte K. Meta-analysis of cognitive-behavioral treatments for Generalized Anxiety Disorder: A comparison with pharmacotherapy. Psychol Bull. 2005 Sep;131(5):785-795. [PubMed] [CrossRef]
8. Lenze EJ, Mulsant BH, Mohiman J, Shear MK, Dew MA, Schulz R, et al. Generalized anxiety disorder in late life: lifetime course and comorbidity with major depressive disorder. Am J Geriatr Psychiatry. 2005 Jan; 13(1):77-80. [PubMed]
9. Sramek JJ, Zarotsky V, Cutler NR. Generalized anxiety disorder: treatment options. Drugs.2002; 62(11):1635-48. [PubMed]
10. Bandelow B, Chouinard G, Bobes J, Ahokas A, Eggens I, Liu S, et al. Extended-release quetiapine fumarate (quetiapine XR): a once-daily monotherapy effective in generalized anxiety disorder. Data from a randomized, double-blind, placebo-and active-controlled study. Int J Neuropsychopharmacol. 2010 Apr;13(3):305-20. [PubMed] [CrossRef]
11. Katila H, Mezhebovsky I, Mulroy A, Berggren L, Eriksson H, Earley W, et al. Randomized, Double-Blind Study of the Efficacy and Tolerability of Extended Release Quetiapine Fumarate (Quetiapine XR) Monotherapy in Elderly Patients With Major Depressive Disorder. Am J Geriatr Psychiatry. 2012 Jun 7. [Epub ahead of print] [PubMed]
12. Mezhebovsky I, Mägi K, She F, Datto C, Eriksson H. Double-blind, randomized study of extended release quetiapine fumarate (quetiapine XR) monotherapy in olderpatients with generalized anxiety disorder. Int J Geriatr Psychiatry. 2013 Jun;28(6):615-25. Epub 2012 Oct 16. [PubMed] [CrossRef]
13. Gao K, Sheehan DV, Calabrese JR. Atypical antipsychotics in primary generalized anxiety disorder or comorbid with mood disorders. Expert Rev Neurother. 2009 Aug;9(8):1147–1158. [PubMed] [CrossRef]
14. Diala CC, Muntaner C. Mood and anxiety disorders among rural, urban, and metropolitan residents in the United States. Community Ment HLT J. 2003 Jun;39(3):239-252. [PubMed] [CrossRef]
15. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. 2010 Feb;27(2):190-211. [PubMed] [CrossRef].
Accepted for publication: 05 April 2013
Published online: 28 June 2013
back to Online Journal