[Treatment of anxiety and panic attacks in geriatric psychiatry]

For the treatment of anxiety disorders and panic attacks in elderly patients a multidimensional approach including pharmacotherapy, psychotherapy and behavioral modification is crucial. More than in younger patients side effects of drugs have to be taken into account. For the long-term treatment only a few psychotropic drugs are recommended. Useful substances are antidepressants including tricyclics and the newer class of SSRI. Buspirone may also play a role in the long-term pharmacotherapy of anxiety disorders. Neuroleptics, benzodiazepines and betablockers should only be prescribed after careful evaluation; by and large, they are of minor significance in the long-term strategy due to significant adverse effects. The pharmacological treatment should always be accompanied by psychotherapy. In particular, behavioral therapy and behavioral modification strategies are of benefit.