What are the FDA approved medications for a 71-year-old patient with anxiety?

From the Guidelines

For a 71-year-old patient with anxiety, the most appropriate FDA-approved medication option is buspirone, starting with a low dose of 5 mg twice daily and titrating up to a maximum of 20 mg three times daily, as it has minimal sedation and is less likely to cause dependence or cognitive impairment compared to benzodiazepines 1. When considering treatment options for anxiety in elderly patients, it is essential to prioritize medications with a favorable safety profile and minimal risk of adverse effects.

• Buspirone is a nonbenzodiazepine anxiolytic that is useful for patients with mild to moderate agitation and has a lower risk of tolerance, addiction, and cognitive impairment compared to benzodiazepines 1.
• Benzodiazepines, such as lorazepam and oxazepam, can be used for short-term management of anxiety but should be avoided for long-term use due to the risk of dependence, falls, and cognitive impairment in older adults 1.
• Other medication options, such as antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may also be effective for anxiety but may have a higher risk of side effects and interactions in elderly patients.
• When prescribing any medication for anxiety in elderly patients, it is crucial to start with a low dose and titrate slowly to minimize the risk of adverse effects and to monitor regularly for therapeutic response and potential interactions with other medications 1.

From the FDA Drug Label

Sertraline is a prescription medicine used to treat depression... Sertraline is also used to treat: ... Social Anxiety Disorder Buspirone hydrochloride tablets are indicated for the management of anxiety disorders or the short-term relief of the symptoms of anxiety.

The FDA approved medications for a 71-year-old patient with anxiety are:

• Sertraline 2, which is used to treat Social Anxiety Disorder.
• Buspirone 3, which is used for the management of anxiety disorders.

It is essential to consult a healthcare provider to determine the best course of treatment, as they will assess the patient's overall health and medical history to recommend a suitable medication and dosage.

From the Research

FDA Approved Medications for Anxiety in the Elderly

The following medications are considered FDA approved for the treatment of anxiety in a 71-year-old patient:

• Antidepressants, specifically:
  • Selective serotonin reuptake inhibitors (SSRIs) 4, 5, 6, 7, 8
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) 4, 7, 8
• Other medications:
  • Mirtazapine 4
  • Vortioxetine 4, 8
  • Buspirone, although it lacks studies in elderly populations 4

Medications to Avoid

The following medications are generally not recommended for the treatment of anxiety in the elderly:

• Benzodiazepines, due to their potential for abuse and dependence 4, 5, 6
• Tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), due to their side effect and safety profiles 4
• Antipsychotics and mood stabilizers, due to their risk of problems in both the long and short term 4
• Beta blockers, which should generally be avoided when treating anxiety in the elderly 4

Considerations for Treatment

When selecting a medication for the treatment of anxiety in a 71-year-old patient, the following factors should be considered:

• The patient's medical history and comorbid conditions 4, 5, 6
• The potential for drug interactions 4
• The patient's preference and ability to adhere to treatment 5
• The need for frequent follow-up and monitoring 5