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26 - Treatment of late-life generalized anxiety disorder

from Section 4 - Treatment of anxiety: current status and controversial issues

Published online by Cambridge University Press:  10 November 2010

By
Laszlo A. Papp ,
Ethan E. Gorenstein  and
, Jan Mohlman
Edited by
Helen Blair Simpson ,
Yuval Neria ,
Roberto Lewis-Fernández  and
Franklin Schneier
Helen Blair Simpson
Affiliation:
Columbia University, New York
Yuval Neria
Affiliation:
Columbia University, New York
Roberto Lewis-Fernández
Affiliation:
Columbia University, New York
Franklin Schneier
Affiliation:
Columbia University, New York
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Summary

This chapter focuses on the specific problems encountered in treating late-life generalized anxiety disorder (GAD). The most common elements of Cognitive-behavioral therapy (CBT) are didactic information about anxiety and instruction in self-monitoring of anxiety, relaxation training, imaginal relaxation, cognitive therapy, worry behavior prevention, problem solving, and gradual exposure to anxiety-provoking stimuli. Selective serotonin reuptake inhibitor (SSRIs) and serotonin-norepinephrine reuptake inhibitor (SNRIs) have replaced tricyclic antidepressants with proven efficacy for GAD as first-line agents. Pharmacotherapy remains the most widely used treatment for managing late-life anxiety. CBT is the best-supported psychosocial treatment for anxiety disorders in younger adults, as well as the best potential alternative to medications. The treatment of GAD is challenging in general, and particularly in the elderly. In all pharmacotherapy, the lowest dosage of medication that controls the patient's symptoms should be prescribed. Insomnia is a frequent symptom of GAD and should be addressed specifically.

Keywords

anxietybrain imagingdepressionserotoninpanic disordersinsular cortexemotional regulationgamma-aminobutyric acid
Type
Chapter
Information
Anxiety Disorders
Theory, Research and Clinical Perspectives
 , pp. 297 - 305
Publisher: Cambridge University Press
Print publication year: 2010

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