Outcomes of late-life anxiety disorders during 32 weeks of citalopram treatment.
BACKGROUND
Anxiety disorders are common in later life, but little is known about the long-term benefits and risks of pharmacotherapy.


METHODS
30 patients aged 60 years and older, with a DSM-IV anxiety disorder, entered a 32-week trial of citalopram. Data gathered at baseline and follow-up included anxiety symptoms using Hamilton Rating Scale for Anxiety (HAM-A) scores, quality of life using the Medical Outcomes Study 36-item Short Form (SF-36), and sleep using the Pittsburgh Sleep Quality Index (PSQI). Data analysis consisted of mixed-effect repeated measures models of HAM-A scores and pre-post comparison of SF-36 and PSQI scores.


RESULTS
30 persons entered treatment; most (27/30) had a primary DSM-IV diagnosis of generalized anxiety disorder (2 had panic disorder; 1 had posttraumatic stress disorder). Three subjects discontinued study medication due to side effects, 5 were terminated because of nonresponse, and 5 dropped out of the study for other reasons; thus, 17 subjects (57%) completed 32 weeks of treatment. Subjects' HAM-A scores improved significantly, with continuing improvements up until about 20 weeks of treatment. On the basis of a criterion of reduction in HAM-A to < 10 during the trial, 60% (18/30) of subjects were responders. Those who completed the 32-week trial had significant improvements in sleep and quality of life-including social functioning, vitality, mental health, and role difficulties due to emotional problems.


CONCLUSIONS
In this 32-week study of citalopram for elderly persons with anxiety disorders, 60% responded. Those who received a full course of treatment experience significant improvements in quality of life and sleep quality.
Blank
Stephen
S
Intervention Research Center for Late-Life Mood Disorders, the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Lenze
Eric J
EJ
Mulsant
Benoit H
BH
Dew
Mary Amanda
MA
Karp
Jordan F
JF
Shear
M Katherine
MK
Houck
Patricia R
PR
Miller
Mark D
MD
Pollock
Bruce G
BG
Tracey
Barbara
B
Reynolds
Charles F
CF
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D015283:Citalopram; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors