Anxiety (April/May/June)

Date of Issue: 04/01/2022 | Volume: 1 | Number: 3&4

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In This Issue

Clinical Update

Deprescribing Anti-anxiety Medications in Older Adults

Our inclination may be to “not rock the boat” when a patient is stable and not misusing prescribed medication. However, tapering anti-anxiety medications in older adults is often a good idea when considering the risks of falls, sedation, and accidents.

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Expert Q&A

Benzodiazepines in Older Adults

The best evidence for benzodiazepines in the elderly is in panic disorder, followed by phobias, social anxiety disorder, and generalized anxiety disorder. Benzodiazepines are also the mainstay of treating catatonia, rapid eye movement sleep behavior disorder, and alcohol withdrawal

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Clinical Update

Assessment and Treatment of PTSD in the Older Patient

Most patients with trauma histories do not develop PTSD. The prevalence of PTSD is between 1% and 3.5% in late life, making it a common disorder. In older adults, PTSD can be chronic.

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Expert Q&A

An Update on Neuromodulation Techniques for Older Adults

MST is an investigational form of treatment for depression. Similar to electroconvulsive therapy (ECT), MST induces seizures with the intention of therapeutic benefit, but the big difference between MST and ECT is how the seizure is induced. In ECT, you use electricity directly applied to the scalp, whereas with MST you use a magnetic coil. The goal of MST is to induce seizures that are effective in treating depression, but with a lower risk of amnesia or cognitive side effects.

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Research Update

Does Mirtazapine Treat Agitation in Dementia?

Agitation often accompanies dementia. While behavioral interventions are the first line intervention, they are often not fully effective. A variety of medications can be used to treat behavioral symptoms, but not without risk. Antipsychotics increase mortality rates in patients with dementia.

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