According to a 2005 report from the Geriatric Mental Health Foundation, anxiety occurs in 10 percent of the elderly population. The most commonly diagnosed condition is generalized anxiety disorder, and symptoms are often linked to decreased physical activity, decreased life satisfaction and increased loneliness. The elderly population presents specific concerns for pharmacological treatment due to co-occurring health conditions. Anxiety medications are typically prescribed at a lower dosage for the elderly to prevent disturbing side effects.
Benzodiazepines
The benzodiazepine class of medications is primarily used to quickly treat intense anxiety. The University of Maryland Medical Center notes that these drugs are prescribed in a lower dosage to the elderly for periods of time not extending past six weeks. Increased risk of falls are associated with use of benzodiazepines due to the side effect of drowsiness and possible disruption in coordination. The American Geriatric Society warns that this class of medications may also cause difficulty in thinking, such as forgetfulness and decreased attention, often appearing similar to symptoms of dementia. Once the medication is stopped, normal cognition should return pending additional physician evaluation for other causes of thinking disturbance. Clonazepam, lorazepam and alprazolam are generic brands of benzodiazepines used for anxiety relief in the elderly.
Antidepressants
Antidepressants can be used for longer-term relief of anxiety in the elderly. The Geriatric Mental Health Foundation indicates that antidepressants take up to six weeks before symptoms of anxiety subside. The benefit of taking antidepressants is longer-term relief of symptoms with fewer side effects. However, the American Geriatric Society warns that "rebound anxiety" may occur once medication is stopped. This means that the anxiety may return since natural chemical levels in the brain are no longer balanced by the medication, and symptoms may intensify. This should be explored with a physician prior to using any medication for treating anxiety. Venlafaxine and duloxetine are prescribed for treating generalized anxiety in the elderly; however, those with a history of heart conditions, glaucoma and liver disease are cautioned not to take these particular drugs.
Beta-blockers
Beta-blockers are used primarily to treat high blood pressure and heart conditions, but have also been found useful in decreasing anxiety in the elderly.The University of Maryland Medical Center explains that beta-blockers relieve the physiological symptoms associated with anxiety, such as rapid heart rate. Beta-blockers such as propanolol and atenolol are more effective for symptom management of certain phobias rather than daily anxiety management.
These drugs are suggested for use prior to entering a situation that may provoke anxiety, such as a meeting with a large group. Beta-blockers are used off-label for anxiety treatment. Consultation with a physician about dosage and effectiveness is suggested prior to considering this drug for anxiety relief.
References
- University of Maryland Medical Center: Anxiety Disorder Medications
- Psychiatric Clinics of North America: Evidence-Based Treatment of Geriatric Anxiety Disorders: Wetherell, Lenze and Stanley, 2005
- Geriatric Mental Health Foundation: Anxiety and Older Adults
- American Geriatrics Association: Anxiety Drug Therapy
- Anxiety Disorders Association of America: Older Adults
