Escitalopram and CBT Found to Prevent Relapse in Elderly with GAD

Cognitive-behavioral therapy (CBT) has been found to enhance antidepressant treatment in older adults by reducing worrying in the short term and sustaining remission without long-term pharmacotherapy. Thus, adding CBT may be a useful treatment option for some patients as standard first-line treatment, researchers concluded in a study reported in the July American Journal of Psychiatry.

The study subjects were 60 years or older with generalized anxiety disorder who had been recruited from three outpatient sites. Subjects received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10–20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. The four groups did not differ on demographic variables or anxiety or worry level at pretreatment.
The researchers found that escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo.

“Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy.” the researchers wrote.


To access the study, click here.

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