Most effective, least worrisome therapies for late-life anxiety

Delivering CBT in primary care. Integrating CBT into anxious older patients’ primary care may be desirable because:

• Older adults prefer to receive psychiatric care in this setting.⁴⁰
  
• Collaborative-care models for depressed and anxious older adults have been successful.⁴¹
  

In collaborative-care models, psychiatrists may supervise a specialized case manager who may identify patients with depression and provide assessment findings and antidepressant treatment support to the patient’s primary care physician. The specialized case manager also may provide psychoeducational information, support, and limited psychotherapy to patients.

A small pilot study that provided CBT in a primary care setting for older adults who met DSM-IV-TR criteria for GAD found statistically and clinically significant declines in self-reported worry, depression, and GAD symptom severity compared with patients receiving care as usual.⁴²

Related resources

• Anxiety Disorders Association of America. www.adaa.org.
  
• Lauderdale SA, Kelly K, Sheikh JI. Anxious older adults: prevalence, assessment, and treatment. In: Anthony ME, Maletta GJ, eds. Principles and practice of geriatric psychiatry. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:429-48.
  

Drug brand names

• Buspirone • BuSpar
  
• Citalopram • Celexa
  
• Duloxetine • Cymbalta
  
• Escitalopram • Lexapro
  
• Fluoxetine • Prozac
  
• Fluvoxamine • Luvox
  
• Lorazepam • Ativan
  
• Mirtazapine • Remeron
  
• Oxazepam • Serax
  
• Paroxetine • Paxil
  
• Sertraline • Zoloft
  
• Venlafaxine • Effexor
  

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.