Anxiety (April/May/June)

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

Issue Links:Learning Objectives

Dr. Meyen shares tips on how to deprescribe anti-anxiety medications, while Dr. Aiken focuses on the appropriate use of benzodiazepines in older adults. Dr. Lisanby provides updates on a variety of neuromodulation techniques including MST, VNS, DBS, TDCS and theta burst stimulation. We also review the assessment and treatment of PTSD in older adults.

In This Issue

Clinical Update

Deprescribing Anti-Anxiety Medications in Older Adults

Topics: anticonvulsants | antihistamines | Antipsychotics | Anxiety | Benzodiazepines | Buspirone | Deprescribing | EMPOWER trial | gabapentin | Mirtazapine | SNRIs | SSRIs | taper | Trazodone | Z-drugs

When should we consider deprescribing anti-anxiety medications in older adults? And how do we get our patients on board with our plan? Here we discuss the risks of commonly used anti-anxiety agents and provide slow taper schedules.

Read More
Expert Q&A

Benzodiazepines in Older Adults

Topics: Addiction | Anxiety | Ashton manual | Beers criteria | Benzodiazepines | Cognitive Behavioral Therapy for Insomnia | Dementia | Fall risk | Hypnotics | Insomnia | Opioids | Overdose | Silexan | taper | Withdrawal

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

Read More
Clinical Update

Assessment and Treatment of PTSD in the Older Patient

Topics: clonidine | Cognitive Behavioral Therapy | cognitive processing therapy | Eye movement desensitization and reprocessing | PCL-5 | Prazosin | Prolonged exposure | PTSD | screening | Trauma | Trauma-focused psychotherapy

PTSD may be missed in older adults leading to worse health outcomes. Here we discuss screening tools for PTSD and how to think through the best treatment options.

Read More
Expert Q&A

An Update on Neuromodulation Techniques for Older Adults

Topics: Anxiety | Deep brain stimulation (DBS) | Dementia | Depression | ECT | Electroconvulsive therapy | magnetic seizure therapy (MST) | mild cognitive impairment | Neuromodulation | Obsessive compulsive disorder/OCD | Personality Disorders | SAINT protocol | Theta burst stimulation | TMS | Transcranial direct current stimulation (TDCS) | Transcranial Magnetic Stimulation | Vagus nerve stimulation (VNS)

Dr. Lisanby introduces us to novel neuromodulation techniques including magnetic seizure therapy, theta burst stimulation, and the SAINT protocol. Plus, she reviews how current and novel neuromodulation treatments can lower the risk of cognitive side effects in older adults.

Read More
Research Update

Does Mirtazapine Treat Agitation in Dementia?

Is mirtazapine effective in treating agitation in dementia? This study decreases our confidence in this medication, at least in the high doses used.

Read More
CME Post-Test

CME Post-Test - Anxiety, CGPR, April/May/June 2022

Topics: CME Post-Test

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME Credits

Read More