Magazine article Clinical Psychiatry News

Consider Medication Early in Older Patients with GAD

Magazine article Clinical Psychiatry News

Consider Medication Early in Older Patients with GAD

Article excerpt

EXPERT ANALYSIS FROM THE ADAA ANNUAL CONFERENCE

LA JOLLA, CALIF.--When older patients with generalized anxiety disorder refuse to begin a course of medication treatment for their symptoms, Julie Wetherell, Ph.D., builds a case for why they should reconsider.

"I'll say something like, 'We can try to approach your problem without medication, but the evidence suggests that a pharmacotherapy approach carefully tailored and closely monitored may be more helpful for you than what we're going to be able to do without medication,'" she said at the annual conference of the Anxiety and Depression Association of America.

"After seeing enough data and enough cases where it was really difficult for me to make a dent without some kind of medication on board, I have come to a realization that I need to start that discussion up front. And if they're willing to try a medication, I refer them to a geriatric psychiatrist colleague," she said.

Dr. Wetherell, a psychotherapist with the University of California, San Diego, likes to begin older patients with generalized anxiety disorder (GAD) on a course of relaxation training "because it seems to be as effective, if not more so, than the full CBT [cognitive-behavioral therapy] package for GAD in later life," she said. "For panic disorder in older adults, the data are starting to look more positive. A recent study found that CBT was as effective as an SSRI [selective serotonin reuptake inhibitor] medication. Unfortunately, we still don't know a lot about the effects of CBT on PTSD [posttraumatic stress disorder] and phobias in older people. …

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