Cognitive-Behavioral Therapy for Management of Anxiety and Medication Taper in Older Adults

Department of Psychiatry, Columbia University, New York, NY 10032, USA.
American Journal of Geriatric Psychiatry (Impact Factor: 3.52). 11/2005; 13(10):901-9. DOI: 10.1176/appi.ajgp.13.10.901
Source: PubMed

ABSTRACT The authors hypothesized that patients with late-life anxiety undergoing cognitive-behavioral therapy plus medical management for medication taper (CBT-MM) would realize greater reduction in medication use and greater improvement in psychological symptoms than a control group undergoing medical management alone (MM).
Forty-two patients (age >60) who wanted to reduce anxiolytic medication were allocated to the two groups (CBT-MM versus MM), using a randomization plus difference-minimization procedure (to equate for medication use).
CBT-MM completers significantly reduced medication use, but not at a greater rate than MM completers. At the same time, CBT-MM completers experienced significantly greater alleviation of psychological symptoms than did MM completers. Some, but not all, treatment gains were maintained at 6-month follow-up. Intention-to-treat analyses using the mixed-effects model showed similar, but weaker, treatment effects than completer analyses.
Cognitive-behavioral therapy can alleviate psychological symptoms in elderly patients with anxiety even as patients reduce anxiolytic medication.

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