A declaration by the World Health Organization (WHO) could raise the profile of traditional or alternative health treatments such as acupuncture and herbal medicine. The WHO has called on member countries to integrate traditional medicine (TM) into their national health systems and for countries to share experience and information related to national policy, regulation, research,
Full Post: Alternative health treatments get a boost from WHO
Many older adults worry - a lot. Almost one in 10 Americans over age 60 suffer from an anxiety disorder that causes them to worry excessively about normal things - like health, finances, disability and family.
Although antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs) can improve anxiety symptoms in younger adults, little has been known about their effects in older people.
In the largest study of SSRIs in older people with anxiety disorders, a team of psychiatric researchers found the drug escitalopram (Lexapro) improved anxiety symptoms and quality of life. Results are reported in the Jan. 21 issue of the Journal of the American Medical Association .
Patients in the study had Generalized Anxiety Disorder (GAD), a condition of chronic, difficult-to-control worry. Associated symptoms include insomnia, fatigue, muscle tension and irritability.
“A person with Generalized Anxiety Disorder spends, on average, about 40 hours a week worrying, so it’s almost like having a full-time job,” says principal investigator Eric J. Lenze, M.D., associate professor of psychiatry at Washington University School of Medicine in St. Louis. “They worry about very real things, but the inability to put those worries out of their minds makes the condition disabling.”
Older adults with anxiety disorders are typically either not treated or prescribed sedative drugs known by trade names such as Valium? and Xanax?. Sedatives can relieve anxiety, but their long-term use in older adults is linked to falls and cognitive impairment. SSRI drugs are thought to be a safer alternative, but it wasn’t clear if they could reduce anxiety in this age group.
Lenze led the study while at the University of Pittsburgh. His team studied 177 people over the age of 60. Average age was about 73.
Half received the SSRI drug escitalopram, and the rest took an inactive placebo. Participants took one pill per day. If their symptoms didn’t improve after four weeks, a second pill was added. In patients receiving the drug, taking two pills increased the dosage from 10 mg. to 20 mg. The higher dose more effectively reduced anxiety.
After 12 weeks of treatment, 68 percent of patients taking escitalopram had improved. About 51 percent of those taking the placebo showed improvement.
“We found improvements not only in anxiety and level of worry but also in functioning,” Lenze says. “Many people who took the drug felt they were better able to carry out daily role activities related to their work or family life.”
Interestingly, the researchers also noted that escitalopram helped some patients lower blood pressure.
“We noticed if their blood pressure was normal, it stayed the same. If they had high blood pressure, it got better,” he says. “It’s a preliminary finding, and more research is needed, but it suggests that anxiety treatment in this age group can help with other health problems.”
The main side effect of escitalopram in this study was fatigue and sleepiness. That surprised the research team because the drug is not a sedative; however, the symptoms usually went away after a few weeks, and the drug was well tolerated overall.
Although escitalopram helped, Lenze calls the benefits modest.
“That doesn’t mean an older adult shouldn’t take an SSRI for an anxiety disorder, but it appears the medication alone usually won’t be sufficient,” he says. “We’re currently conducting a study that combines drug treatment with a type of psychotherapy called cognitive behavior therapy.”
That study includes investigators at the University of Pittsburgh, the University of California at San Diego and Washington University. This study treats patients for 56 weeks. Lenze believes the long-term nature of the study will provide better answers about how to effectively treat anxiety in older adults and whether doing so improves health.
“Most older adults with an anxiety disorder never see a mental health specialist,” Lenze says. “They are more likely to see a gastroenterologist for GI difficulties or a rheumatologist for muscle pain than to go to a psychiatrist. They may feel stress and worry about things, but some other symptom is what gets them to go to the doctor.”
http://www.wustl.edu/
--------------------------------------------------------------------------------------------
Related Posts:
For older adults who have lived through the Great Depression, news stories comparing present circumstances to the harsh realities of food lines, few jobs, and extreme poverty of the 1930’s may be panic-producing. Add that to the fact that an economic crisis disproportionately affects older adults who need access to retirement funds, and it’s not
Full Post: Seniors are feeling anxious
A new study shows that antidepressant drugs which only affect serotonin, often used as first choice treatments, may not be best for depression in people with Parkinson’s disease. The new research is published in the December 17, 2008, online issue of Neurology, the medical journal of the American Academy of Neurology. Depression affects up to
Full Post: Tricyclic antidepressants best for depression in Parkinson’s
Adding another reason for people to watch their blood pressure, a new study from North Carolina State University shows that increased blood pressure in older adults is directly related to decreased cognitive functioning, particularly among seniors with already high blood pressure. This means that stressful situations may make it more difficult for some seniors to
Full Post: Increased blood pressure in older adults affects cognitive functioning
Eli Lilly and Company has withdrawn its supplemental New Drug Application (sNDA) from the U.S. Food and Drug Administration (FDA) for Cymbalta (duloxetine HCl) for the management of chronic pain. Lilly plans to resubmit the application in the first half of 2009, adding data from a recently completed positive study in chronic osteoarthritis pain of
Full Post: Eli Lilly withdraws application for additional U.S. indication for Cymbalta for chronic pain
Cold weather may raise blood pressure in elderly. In new research French are suggesting that elderly people may be more at risk of suffering a stroke, heart attack or kidney failure in winter because cold weather may raise their blood pressure. The researchers from the National Institute of Health and Medical Research in Paris say
Full Post: Elderly more at risk of heart attack in cold weather --------------------------------------------------------------------------------------------
