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Combining Antidepressant with Therapy Key for Seniors with Anxiety

Update Date: Jun 25, 2013 03:56 PM EDT
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Nearly one in 20 senior citizens suffer from a generalized anxiety disorder. Currently, doctors tend to prescribe medications such as benzodiazepines, which are psychoactive drugs used to treat several mental illnesses. Since this group of drugs can be risky for older people, some researchers have been focused on finding or creating a better treatment plan. In a new study, researchers from the Washington University School of Medicine in St. Louis, the University of California, San Diego, and the University of Pittsburgh came together to test the effects of combining an antidepressant with cognitive behavioral therapy (CBT) on senior citizens with a generalized anxiety disorder.

"Benzodiazepines are particularly risky in older adults because they can contribute to falls and to cognitive impairment," said Eric J. Lenze, MD, professor of psychiatry at Washington University reported by Medical Xpress. Lenze is also a geriatric psychiatrist. "Our theory is that generalized anxiety disorder has two components. One is a generally high stress level that might be managed with antidepressant medication, but the other is excessive worry. Some people are pathological worriers, and we thought that might be helped by cognitive behavioral therapy."

For this study, the researchers used the antidepressant, escitalopram. They recruited 73 patients that all had anxiety issues and were over 60-years-old. There were three main parts to the experiment. First, the researchers started administering escitalopram to all participants for three months. Then, they randomly split the group in half. The first group continued taking the antidepressant while the second group took the antidepressant and also received CBT for another 16 weeks. CBT was designed to inform the elders about the human nature of worrying as well as teaching them relaxation methods to use, such as deep breathing and muscle relaxation. At this point, the researchers noted that both groups exhibited improvement but group two had more improvement in terms of the standard measure of worry pathology.

After this part of the experiment, the researchers combined the groups and once again, randomly divided them into two. The first group now continued taking the antidepressant for 28 weeks but was weaned off of it by week 56. The second group started receiving a placebo. The researchers found that after week 56, the first group had a lower relapse rate. Furthermore, if they relapsed, it occurred much later than group two.

This study suggests the combining escitalopram with CBT could be very beneficial for seniors with a generalized anxiety disorder. However, treatment plans should always be determined based on an individualistic approach with one's physician. The study was published in The American Journal of Psychiatry

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