title: Cognitive-behavioral therapy for management of anxiety and medication taper in older adults.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Cognitive-behavioral therapy can alleviate psychological symptoms in elderly patients with anxiety even as patients reduce anxiolytic medication.
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY 10032, USA. EEG1@columbia.edu
authors.forename: Ethan E
authors.initials: EE
authors.lastname: Gorenstein
authors.forename: Marc S
authors.initials: MS
authors.lastname: Kleber
authors.forename: Jan
authors.initials: J
authors.lastname: Mohlman
authors.forename: Marybeth
authors.initials: M
authors.lastname: Dejesus
authors.forename: Jack M
authors.initials: JM
authors.lastname: Gorman
authors.forename: Laszlo A
authors.initials: LA
authors.lastname: Papp
mesh_terms: D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy*; D001569:Benzodiazepines / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009294:Narcotics / Q000627:therapeutic use*
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D009294:Narcotics; D001569:Benzodiazepines