Use of Benzodiazepines and Selective Serotonin Reuptake Inhibitors in Middle-Aged and Older Adults With Anxiety Disorders: A Longitudinal and Prospective Study

Benítez, Carlos I. Pérez; Smith, Kévin; Vasile, Russell G.; Rende, Richard; Edelen, Maria Orlando; Keller, Martin B.

doi:10.1097/jgp.0b013e31815aff5c

Cited by 47 publications

(39 citation statements)

References 31 publications

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“…Indeed, benzodiazepines are the most common form of medication used to treat the elderly for anxiety disorders, despite the serious adverse effects they may cause, including increased risk of hip fracture [152] and impaired cognitive and psychomotor functioning. [153,154] Unfortunately, few randomized clinical trials (RCTs) have been conducted for both pharmacological and psychosocial treatments for anxiety disorders in the elderly population relative to the younger adult population. Despite this, there are a sufficient number of existing studies to draw preliminary conclusions about the efficacy of particular treatment approaches.…”

Section: Treatment Efficacymentioning

confidence: 99%

Anxiety disorders in older adults: a comprehensive review

Wolitzky-Taylor¹,

Castriotta²,

Lenze³

et al. 2010

Depress. Anxiety

600

398

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This review aims to address issues unique to older adults with anxiety disorders in order to inform potential changes in the DSM-V. Prevalence and symptom expression of anxiety disorders in late life, as well as risk factors, comorbidity, cognitive decline, age of onset, and treatment efficacy for older adults are reviewed. Overall, the current literature suggests: (a) anxiety disorders are common among older age individuals, but less common than in younger adults; (b) overlap exists between anxiety symptoms of younger and older adults, although there are some differences as well as limitations to the assessment of symptoms among older adults; (c) anxiety disorders are highly comorbid with depression in older adults; (d) anxiety disorders are highly comorbid with a number of medical illnesses; (e) associations between cognitive decline and anxiety have been observed; (f) late age of onset is infrequent; and (g) both pharmacotherapy and CBT have demonstrated efficacy for older adults with anxiety. The implications of these findings are discussed and recommendations for the DSM-V are provided, including extending the text section on age-specific features of anxiety disorders in late life and providing information about the complexities of diagnosing anxiety disorders in older adults. Depression and Anxiety 27:190-211, 2010.

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Section: Treatment Efficacymentioning

confidence: 99%

Anxiety disorders in older adults: a comprehensive review

Wolitzky-Taylor¹,

Castriotta²,

Lenze³

et al. 2010

Depress. Anxiety

600

398

View full text Add to dashboard Cite

show abstract

“…Compared to a number of studies examining benzodiazepine use in older persons with depression (Butler, Collins, Katona, & Orrell, 2000;Valenstein et al, 2004) or mixed diagnoses (Cheng et al, 2008;Rochon et al, 2004;Veronese et al, 2007), available cross-sectional prescription surveys in older patients with anxiety disorders are still limited (Benitez et al, 2008;Kirby et al, 1999;Linden, Bar, & Helmchen, 2004;Schuurmans et al, 2005). There are five notable studies that found prescription rates of benzodiazepines to be 44% (Kirby et al, 1999), 33% (Linden et al, 2004), 41-53% (Benitez et al, 2008), 27% (Schuurmans et al, 2005), and 83.9% (Balestrieri et al, 2005), respectively, in older patients with anxiety disorders. However, the first two studies involved only small numbers of patients with anxiety disorders (n = 18 and n = 85, respectively) even though the sample sizes of total study participants were large (n = 1701 and n = 516, respectively) (Kirby et al, 1999;Linden et al, 2004).…”

Section: Introductionmentioning

confidence: 90%

Benzodiazepine and antidepressant use in elderly patients with anxiety disorders: A survey of 796 outpatients in Japan

Uchida

Suzuki

Mamo

et al. 2009

Journal of Anxiety Disorders

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“…Benzodiazepines continue to be one of the most frequently prescribed treatments for GAD, 64 are associated with significant cognitive impairment and sedation in the elderly. 65 In contrast, the results of large, double-blind clinical trial of pregabalin in GAD in elderly outpatients found that treatment with pregabalin was not associated with any impairment on a cognitive battery that included DSST, digit span, and the set test.…”

Section: Safety/tolerability In the Elderlymentioning

confidence: 99%

Pharmacotherapy Update: Pregabalin in the Treatment of Generalized Anxiety Disorder

Montgomery

Kasper

2010

Clinical Medicine Insights: Therapeutics

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Generalized anxiety disorder (GAD) is a common disorder that is chronic, disabling, and often goes undiagnosed. Currently, four distinct classes of medications have demonstrated efficacy in the treatment of GAD: benzodiazepines, serotonin and/or norepinephrine reuptake inhibitors (SSRIs/SNRIs), histamine H 1 receptor blockers (hydroxyzine), and pregabalin. Pregabalin acts via binding to an α2-δ subunit presynaptic membrane protein that inhibits neurotransmitter release in excited neurons. Pregabalin is renally excreted and undergoes minimal (2%) hepatic metabolism, thus limiting the risk of drug-drug interactions. The efficacy of pregabalin for the treatment of GAD has been established based on the results of 8 double-blind, placebo-controlled, short-term led trials, and one 6-month relapse prevention study. The current review summarizes data showing that pregabalin has a significantly different safety profile from the benzodiazepines (eg, less sedation, less cognitive and psychomotor impairment, less risk of dependence and withdrawal), and SSRI/ SNRI anxiolytics (eg, less gastrointestinal side effects and sexual dysfunction). The review also summarizes efficacy data showing that pregabalin is a broad spectrum anxiolytic that with a speed of onset similar to the benzodiazepines.

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Use of Benzodiazepines and Selective Serotonin Reuptake Inhibitors in Middle-Aged and Older Adults With Anxiety Disorders: A Longitudinal and Prospective Study

Cited by 47 publications

References 31 publications

Anxiety disorders in older adults: a comprehensive review

Anxiety disorders in older adults: a comprehensive review

Benzodiazepine and antidepressant use in elderly patients with anxiety disorders: A survey of 796 outpatients in Japan

Pharmacotherapy Update: Pregabalin in the Treatment of Generalized Anxiety Disorder

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