Treatment of anxiety in the elderly

Elderly patients have a higher prevalence of clinically significant anxiety than younger patients. The anxiety is usually comorbid with depression, medical illness, dementia, or personality disorders, and all of these factors impact on treatment. Further complicating treatment are age-related changes in the pharmacokinetics and pharmacodynamics of anxiolytics in this patient population. Benzodiazepines, buspirone, beta-blockers, antidepressants, neuroleptics, and antihistamines are useful in treating anxiety in older patients, but individual patient physiologic and psychological characteristics need to be considered in choosing an appropriate agent.