Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines, another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
SSRIs and SNRIs, the first-line medications for anxiety, are considered safer alternatives to non-controlled substances. Anxiety disorders are the most common group of psychiatric disorders in both adults and adolescents.
First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for routine use. Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others.
SSRIs and SNRIs are often the first-line treatment for anxiety. Common SSRI brands are Celexa, Lexapro, Luvox, Paxil, and Zoloft. Common SNRI brands are Pristiq, Cymbalta, and Effexor XR. Pros: They are effective for a lot of people and they have a solid safety profile.
Short-half-life benzodiazepines, such as oxazepam, alprazolam, and triazolam, are usually recommended for older adults, because these agents do not accumulate in the blood, are rapidly cleared from circulation, and offer greater dosage flexibility.
SSRIs. This group of drugs, including fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Cipralex) and sertraline (Zoloft), is usually the first choice for treatment of depression and anxiety disorders.
SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft). Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants.
The tolerability profile of sertraline is generally similar in younger and elderly patients. Sertraline has a low potential for drug interactions at the level of the cytochrome P450 enzyme system. In addition, no dosage adjustments are warranted for elderly patients solely based on age.
SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline. [16] These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.
Buspirone belongs to a classification of drugs called anxiolytics. These drugs work to decrease symptoms of anxiety. Buspirone comes as an oral tablet (a tablet taken by mouth) that's typically taken twice per day.
A second therapeutic candidate, LYT-310 (oral cannabidiol), is expected to enter the clinic in Q4 of 2023.
Selective serotonin reuptake inhibitors. These include fluoxetine (aka Prozac), paroxetine (aka Paxil), sertraline (aka Zoloft), fluvoxamine (aka Luvox), citalopram (aka Celexa), and escitalopram (aka Lexapro). They tend to be the first line choice for multiple anxiety disorders and depression.
Persons over the age of 65 are at the greatest risk for adverse effects from benzodiazepine drugs like Ativan (lorazepam) or Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Librium (chlordiazepoxide) and Tranxene (clorazepate dipotassium).
However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness) and kidney, liver, or lung problems, which may require caution and an adjustment in the dose for patients receiving this medicine.
However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness or unsteadiness) and age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose.
These medications take effect almost immediately and usually start to wear off within a few hours. They should not be taken daily unless your doctor explicitly recommends it.
It's recommended to keep taking your medication for at least 12 months if you're benefiting from it. This is meant to help prevent symptoms from getting worse again. After 12 months or so, you and your healthcare provider may decide to continue the medication or to gradually stop taking it.
Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.