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Generalized anxiety disorder (GAD), seen in up to 7.3% of older adults, is generally chronic and is associated with risk for cardiovascular and cognitive impairment and higher healthcare utilization. Pathological worry may be even greater in older than in younger patients. This multisite, three-phase study involved 73 patients at least age 60 with GAD who received the selective serotonin reuptake inhibitor (SSRI) escitalopram (10–20 mg/day) for the 12-week initial phase and were then randomized to one of four groups:
16 weeks of escitalopram plus cognitive-behavioral therapy (CBT); then, 28 weeks of maintenance escitalopram
Escitalopram plus CBT; then, maintenance placebo
Escitalopram-only throughout augmentation and maintenance phases
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