A Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient

Journal of Geriatric Psychiatry and Neurology, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 1, 2024

Background This is a new algorithm from the Psychopharmacology Algorithm Project at Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed. Results Selective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with preference for sertraline or escitalopram. If avoiding sexual side effects priority, buspirone an option relatively healthy adult. response inadequate, second recommended trial different SSRI one of serotonin-norepinephrine update (SNRIs), venlafaxine duloxetine. For third medication trial, additional alternatives added previous options now include pregabalin/gabapentin, lavender oil, agomelatine. there unsatisfactory chosen, quetiapine may considered. We recommend caution following acute treatment this population: benzodiazepines hydroxyzine. Other agents given low priority but having some supportive evidence vilazodone, vortioxetine, mirtazapine, cannabidiol. Acknowledging that median age onset GAD early adulthood, many patients will have been started (or other medications require elderly) younger age. These continued regular observation see if potential harms starting exceed benefits switch justified.

Language: Английский

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The Organization of Anxiety Symptoms Along the Threat Imminence Continuum

Current topics in behavioral neurosciences, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Language: Английский

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