Anxiety disorders in the elderly do not remit spontaneously. However, only few studies have focused on treatment of anxiety of the aged. Only placebo-controlled studies are conclusive, until effect of drug treatment have been proven. Short time effect of benzodiazepines or other anxiolytic drugs have been found in four different studies, one of them also in comparison with an arm of imipramine. No study has evaluated the long-term effect of anxiolytics on anxiety in the aged. Withdrawal of benzodiazepines after long-term use is difficult and a gradual tapering is recommended. Effect of antidepressant treatment in the elderly, which also will include depressive/anxiety states, is well documented. In a post hoc analyses the effects of venlafaxine on anxiety, no difference was found between adults and old patients. Imipramine and also buspirone have been shown to reduce anxiety in the elderly. In non-depressive demented patients citalopram was found to reduce anxiety in comparison with placebo. Olanzapine have also been shown to reduce anxiety in demented patients.
A lot of clinical recommendations have been published which highly contrasts with paucity of evidenced data. Thus, the few placebo-controlled studies suggest that benzodiazepines are effective in short-term treatment but their effect in long-term use is uncertain. Antidepressant therapy have been have been found effective, but more studies are needed, before evidence based recommendations could be formulated.
Back to S020 Anxiety in the Elderly; Current Status and an Agenda for the Future
Back to The Eleventh International Congress