Pharmacotherapy for Mood and Anxiety Disorders

Reference work entry
Part of the Mental Health and Illness Worldwide book series (MHIW)

Abstract

Mood and anxiety disorders are common in the elderly. They are associated with significant morbidity and mortality. Unrecognized psychiatric conditions may have a significant negative effect on treatment outcomes for somatic disorders. Psychopharmacological treatment strategies should aim to provide not only symptomatic response and remission of symptoms but also full functional recovery. While medications are the mainstay for moderate to severe conditions, the use of adjunctive psychotherapy should also be considered. The selective serotonin reuptake inhibitors have become the first-line pharmacological treatment of depression and anxiety for the elderly. Alternative options (benzodiazepines, other antidepressants, and buspirone), while effective, have drawbacks associated with their use which makes them unsuitable as first-line choices. Clinical use of the selective serotonin reuptake inhibitors requires careful consideration of the mental status of the individual patient, their physical health (robust good health for age or frailty), and the presence of somatic illness. The choice of medication and initial dose will be guided by the interaction of these factors. Careful assessment of response to and monitoring of side effects of medication is essential to ensure optimal outcomes.

Keywords

Depression GAD Elderly Antidepressants Anxiety Benzodiazepines Pregabalin Tricyclics Monoamine oxidase inhibitors SSRIs SNRIs Agomelatine Vortioxetine 

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© Springer Science+Business Media Singapore 2017

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of Melbourne, Austin HospitalHeidelbergAustralia

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