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Escitalopram Plus Behavior Tx Benefits Elderly With Anxiety

For older adults with generalized anxiety disorder, meds plus CBT reduces worry, prevents relapse

THURSDAY, June 27 (HealthDay News) -- For older adults with generalized anxiety disorder, escitalopram combined with cognitive behavioral therapy (CBT) is associated with a reduction in worry and can prevent relapse, according to a study published online May 17 in the The American Journal of Psychiatry.

Julie Loebach Wetherell, Ph.D., from the Veterans Administration San Diego Healthcare System, and colleagues examined whether sequenced treatment combining pharmacotherapy with CBT could boost response and prevent relapse in a cohort of 73 older adults (aged 60 years or older) with generalized anxiety disorder. Participants received 12 weeks of open-label escitalopram and were then randomized to receive one of four conditions: 16 weeks of escitalopram plus CBT or escitalopram alone, followed by 28 weeks of maintenance escitalopram or placebo pill.

The researchers found that, compared with escitalopram alone, escitalopram plus CBT was associated with increased response rates on the Penn State Worry Questionnaire, but not the Hamilton Anxiety Rating Scale. Compared with placebo, both escitalopram and CBT prevented relapse.

"The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short term," the authors write. "Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy."

Two authors disclosed financial ties to the pharmaceutical industry, and one disclosed ties to an e-learning company.

Abstract (http://ajp.psychiatryonline.org/article.aspx?articleid=1688270 )Full Text (subscription or payment may be required) (http://ajp.psychiatryonline.org/article.aspx?articleid=1688270 )