What Is The Best Anti Anxiety Medication For The Elderly

June 25, 2022

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With All These Options How Can You Choose

Alternatives to Anti-Anxiety Drugs that Really Work, with Dr. Daniel Amen

Your doctor can recommend the best medication to help control your anxiety. There are different types of anxiety disorders, so different medications may be better choices for your type. Your doctor will also consider your other health conditions and medications, and whether you have a family history of responding better to a certain medication. Since you might be taking medication long-term, you may want to factor in affordability.

Sleeping Pills Can Have Serious Or Even Deadly Side Effects

All sedative-hypnotic drugs have special risks for older adults. Seniors are likely to be more sensitive to the drugs effects than younger adults.

And these drugs may stay in their bodies longer.

The drugs can cause confusion and memory problems that:

More than double the risk of falls and hip fractures. These are common causes of hospitalization and death in older people.
Increase the risk of car accidents.

Foods That Help Or Hurt Anxiety

There are several types of medications used to treat anxiety disorders.

Hydroxyzine
Beta-blockers

Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects.

Theyre supereffective in treating anxiety disorders, says Beth Salcedo, MD, the medical director of the Ross Center for Anxiety & Related Disorders and a past board president of the Anxiety and Depression Association of America. Its not known exactly how SSRIs work on serotonin to alleviate anxiety, says Dr. Salcedo, but what is known is that theyre not addictive like benzodiazepines are .

Its important to follow your doctors instructions when taking any prescription drug. Talk to your doctor if youre concerned about the side effects of a medication, or if the drug youre taking doesn’t seem to be alleviating your symptoms.

Other antidepressants that may be prescribed for anxiety include:

Wellbutrin, Zyban, Aplenzin, Budeprion, or Buproban
Tricyclic antidepressants, such as Amitid, Amitril, Elavil, or Endep Aventyl, Pamelor or Tofranil

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Diagnosing Depression In Seniors

Family members and caregivers should familiarize themselves with the signs of depression in seniors because mental health issues in older adults are commonly overlooked or mistaken for other health conditions. If you notice any warning signs, its important to encourage your loved one to seek medical help for depression.

While this first step is often intimidating, its easiest to start by making an appointment with a seniors family doctor or primary care physician . Most older adults have a trusted PCP they have been seeing for many years. This rapport helps patients feel more comfortable broaching the subject and makes it easier for doctors to make initial recommendations based on a patients medical history and personality. This established baseline is very important for monitoring changes in an elders mood, behavior and functioning over time.

During the appointment, the doctor will ask about the seniors symptoms, all medications they are taking and how changes in their mood impact their day-to-day life. They should then perform a physical exam to see if new or worsening symptoms of depression could be caused by an underlying health problem or side effects of a medication the patient is taking.

Can Kids Be Prescribed Antidepressants

Best Anti Anxiety Medication For Elderly With Dementia

The FDA has approved antidepressants for children, with use that increases with age. One study from 2018 found that kids in the youngest group of the study got just 0.8% of prescriptions for psychiatric drugs , whereas adolescents accounted for 7.7%. The American Psychological Association reports that 3.4% of kids ages 12-19 have taken antidepressants in the last month.

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Geriatric Depression: The Use Of Antidepressants In The Elderly

ABSTRACT: Depression in the elderly significantly affects patients, families, and communities. Awareness of predisposing and precipitating factors can help identify patients in need of screening with tools such as the Geriatric Depression Scale. After diagnosis, regular follow-up and active medication management are crucial to maximize treatment and remission. Selection of an antidepressant medication should be based on the best side effect profile and the lowest risk of drug-drug interaction. If remission is not achieved, then add-on treatments, including other drugs and psychotherapy, may be considered. In cases of severe, psychotic, or refractory depression in the elderly, electroconvulsive therapy is recommended.

Depression is a common but undertreated condition in the elderly.

Depression is the most common mental health problem in the elderly and is associated with a significant burden of illness that affects patients, their families, and communities and takes an economic toll as well. Prevalence studies suggest that 14% to 20% of the elderly living in the community experience depressive symptoms, with higher rates among the elderly in hospital and even higher rates in long-term care facilities .

There is also often a tendency for people to see their symptoms as part of the normal aging process, which they are not. Depression in the elderly still goes undertreated and untreated, owing in part to some of these issues.

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Safety And Other Considerations

It’s also important to realize that the long term use of a mental health medication is going to have an effect on your wellbeing. Some cause digestion issues. Others cause extreme fatigue. These side effects can have a disruptive effect on your life.

Similarly, some anti-anxiety medications cause dependency with severe withdrawal symptoms if you stop taking it or miss too many doses. Some medications may also lose their effectiveness over time . Keep this in mind and discuss with your doctor when you are choosing the right medication for you.

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Lexapro May Ease Anxiety In Older Adults: Study

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CHICAGO – The popular antidepressant Lexapro showed promise at easing anxiety symptoms in older adults, but the effect was modest and would need to be studied further, U.S. researchers said on Tuesday.

A pedestrian passes a closed store, in north London January 14, 2009. REUTERS/Toby Melville

They said antidepressants like Lexapro, made by Forest Laboratories Inc and known generically as escitalopram, may be useful as a new treatment option for older adults with generalized anxiety disorder, a disabling condition that can also cause muscle tension, insomnia and fatigue.

We found improvements not only in anxiety and level of worry but also in functioning, Dr. Eric Lenze of Washington University School of Medicine in St. Louis, whose study appears in the Journal of the American Medical Association, said in a statement.

He said many people who took the drug were better able to carry out their daily activities. But for most people, he said, the drug alone is likely not enough.

Overall the benefits were fairly modest, Lenze said in a telephone interview. It will help some people a lot. Most people will probably need some sort of combination treatment.

Lenzes team did uncover an unexpected benefit: the drug helped people get their blood pressure under control.

That suggests there can be some long-term health benefits in treating anxiety in this older age group, Lenze said.

Reporting by Julie Steenhuysen Editing by Maggie Fox, Richard Chang

Types Of Anxiety Disorders

Generalized anxiety disorder (GAD) – causes, symptoms & treatment

Having more anxiety as you age is a common issue in older adults. The most common types of anxiety disorders are:

Generalized Anxiety Disorder . This type of anxiety causes racing thoughts, constant worrying, and a feeling of hopelessness. Older adults with GAD arenât able to sleep or concentrate as well. They also feel tired, irritable, and nauseous. They may also have to go to the bathroom often. Hot flashes and feeling out of breath are additional signs of GAD.

âPhobias. This type of anxiety fills people with intense fear of a place, thing, or event. Often, these fears are irrational and are about things that do not pose a real threat.

Common types of phobias for older adults are fear of death, disaster, and danger to the family. A fear of dental procedures is also common. When facing these fears you might feel dizzy, have chest pain, or heart palpitations. Shortness of breath is also common.

Panic disorder. When an older adult has a panic disorder, they can get sudden feelings of terror. This feeling is often accompanied by a racing heart, chest pain, weakness, nausea, and feeling faint or dizzy.

Panic attacks happen randomly and are not necessarily triggered by anything. They usually peak within 10 minutes and then fade away. Older adults with this condition may feel like theyâre having a heart attack or stroke and not want to be left alone.

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Why Are Sleeping Pills Not Helpful

Nearly one third of older people in Canada take sleeping pills. These drugs are called sedative-hypnotics or tranquilizers. They affect the brain and spinal cord.

Health care providers prescribe the drugs for sleep problems. The drugs are also used to treat other conditions, such as anxiety or alcohol withdrawal.

Usually older adults should try non-drug treatments first. There are safer and better ways to improve sleep or reduce anxiety.

Sleeping pills may not help much.

Many ads say that sleeping pills help people get a full, restful nights sleep. But studies show that this is not exactly true in real life. On average, people who take one of these drugs sleep only a little longer and better than those who dont take a drug.

Drug Interactions And Overdose

While benzodiazepines are relatively safe when taken only occasionally and in small doses, they can be dangerous and even deadly when combined with other central nervous system depressants. Always talk to your doctor or pharmacist before combining medications.

Dont drink on benzodiazepines. When mixed with alcohol, benzodiazepines can lead to fatal overdose.

Dont mix with painkillers or sleeping pills. Taking benzodiazepines with prescription pain or sleeping pills can also lead to fatal overdose.

Antihistamines amplify their effects. Antihistaminesfound in many over-the-counter sleep, cold, and allergy medicinesare sedating on their own. Be cautious when mixing with benzodiazepines to avoid over-sedation.

Be cautious when combining with antidepressants. SSRIs such as Prozac and Zoloft can heighten benzodiazepine toxicity. You may need to adjust your dose accordingly.

Paradoxical effects of benzodiazepines

The benzodiazepines work because they slow down the nervous system. But sometimes, for reasons that arent well understood, they have the opposite effect. Paradoxical reactions are most common in children, the elderly, and people with developmental disabilities. They include:

Increased anxiety, irritability, agitation, aggression, and rage
Mania, impulsive behavior, and hallucinations

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I Need Relief And I Need It Now

So where does that leave you if youre suffering? Even when anxiety relief comes with side effects and dangers, that can still sound like a fair trade when panic and fear are ruling your life.

The bottom line is that theres a time and place for anxiety medication. If you have severe anxiety thats interfering with your ability to function, medication may be helpfulespecially as a short-term treatment. However, many people use anti-anxiety medication when therapy, exercise, or other self-help strategies would work just as well or better, minus the drawbacks.

Anxiety medications can ease symptoms, but theyre not right for everyone and theyre not the only answer. Its up to you to evaluate your options and decide whats best for you.

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Does Medicare Or Insurance Cover The Best Anti

Original Medicare doesn’t cover most prescription medications. Prescription anti-anxiety medications taken at home are covered by Medicare Part D, a supplemental prescription plan, or Medicare Advantage Plans that include prescription coverage. Medicare Part D doesn’t cover over-the-counter medications, but some Medicare Advantage Plans include allowances to help beneficiaries purchase medications that don’t require a prescription.

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Medication Isnt Your Only Option For Anxiety Relief

Anxiety medication wont solve your problems if youre anxious because of mounting bills, a tendency to jump to worst-case scenarios, or an unhealthy relationship. Thats where self-help, therapy, and other lifestyle changes come in. These non-drug treatments can produce lasting changes and long-term relief.

Exercise Exercise is a powerful anxiety treatment. Studies show that regular workouts can ease symptoms just as effectively as medication.

Worry busting strategies You can train your brain to stop worrying and look at life from a more calm and balanced perspective.

Therapy Cognitive behavioral therapy can teach you how to control your anxiety levels, stop worrisome thoughts, and conquer your fears.

Yoga and tai chi Yoga and tai chi are mind-body interventions that engage you emotionally, psychologically, and spiritually. Data has shown their efficacy for many different medical conditions, including anxiety.

Mindfulness and meditation Mindfulness is a state of mind where you learn to observe your thoughts, feelings, and behaviors in a present, compassionate, and non-judgmental way. It often brings a sense of calm and relaxation.

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What Does Depression Look Like In Kids

While they can share similar symptoms, kids typically experience depression differently than adults. Children are more likely to present with sudden mood changes, temper tantrums, and irritability rather than a depressed mood, says Natasha Nambiar, MD, a medical advisor for eMediHealth. Difficulty with sleep, weight loss, and anxiety appear more common in younger children, whereas increased eating, weight gain, and slowness in motor activity seem to increase in adolescents.

Medications Used To Treat Anxiety Disorders

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There are four major classes of medications used in the treatment of anxiety. Each class attempts to reduce anxiety in a different way and has its own benefits and risks.

While some may be considered preferred options, drug selection can vary based on the type of anxiety you have and your symptoms. The amount of time you are on the drug can vary as well.

For instance, if you take antidepressant medications, your healthcare provider may recommend that you continue to use them for four to nine months after symptoms have resolved. But if you take benzodiazepines, you should only use them short-term.

Overall, using medications for anxiety disorders is considered safe and effective.

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Dementia Medications To Avoid

It is important to note that there are medications that can actually make dementia worse than it is. When dementia drugs are developed, they are meant to increase Choline levels, which is a chemical that is needed by brain cells to communicate with one another.

However, some drugs can decrease the levels of this chemical and end up worsening dementia and can result in agitation and confusion. They may also cause issues with urination, constipation and a dry mouth.

There are many ailments that can affect dementia patients and they need to be treated. The drugs may have a negative effect on the patient and so alternatives should be sought out.

What Causes Anxiety To Flare Up

Daily stressors like traffic jams or missing your train can cause anyone anxiety. But long-term or chronic stress can lead to long-term anxiety and worsening symptoms, as well as other health problems. Stress can also lead to behaviors like skipping meals, drinking alcohol, or not getting enough sleep.

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What Are The Best Antidepressants For Elderly Patients

When it comes to antidepressants for elderly patients, most experts recommend SSRIs or selective norepinephrine reuptake inhibitors , which help increase certain brain chemicals such as serotonin. These drugs tend to have fewer serious side effects and drug interactions than older antidepressants on the market. They also seem to be just as effective in older people as they are in younger ones, although some doctors suggest starting at half a normal dose and gradually increasing it while watching for side effects and mood improvement. If no improvement is seen after four weeks on a full dose, you may need a different medication.