Talking helps ease anxiety in adults

Adding talk therapy to typical anxiety treatments that often include drugs helped older adults cope better, improving their quality of life and lowering their risk for depression and other health problems, U.S. researchers said.
An increasingly popular type of therapy called cognitive behavior therapy, or CBT, which includes specific problem-solving strategies, significantly improved levels of worry, depression and general mental health compared with those who got usual care such as anti-depressants and anti-anxiety drugs, they said.
"This study is the first to suggest that CBT can be useful for managing worry and associated symptoms among older patients in primary care," Melinda Stanley of the Baylor College of Medicine in Houston, whose study appears in the Journal of the American Medical Association, said in a statement. The findings follow similar results in younger adults, and suggest a new approach to treating anxiety in older adults. About 11 percent of older adults see their primary care doctor for treatment of anxiety, which typically includes a variety of medications. But anti-anxiety drugs such benzodiazepines, a type of tranquilizer, can worsen other problems common to older adults such as falls, hip fractures and memory problems. "Often older adults don't want to add another medication. They are worried about the side effects, the interactions with other medicines," Stanley said in a telephone interview.
She and colleagues wanted to see if cognitive behavior therapy might help. They studied 134 older adults with an average age of 67 who visited their primary care doctor for anxiety symptoms. A 'TOOL KIT' In addition to what their doctor prescribed, about half of the patients also got three months of talk therapy, which included relaxation training, cognitive therapy, problem-solving skills training and sleep management. Stanley described it as a "tool kit" that patients can use when they start to feel anxious.
The other half got enhanced routine care, which included their doctor's treatment plan plus regular telephone calls from therapists to check on how they were doing. Stanley said about 42 percent of the patients in both groups were taking antidepressants or anti-anxiety drugs. At the end of the yearlong study, the people in the therapy group reported significantly improved symptoms on several common scales measuring anxiety. In general, she said she was confident that patients showed a benefit and the benefit seemed to last over a period of several months.
"Often when people stop taking medication the symptoms come back," she said. Generalized anxiety disorder is a disabling condition that can also cause muscle tension, insomnia and fatigue. A study earlier this year found the antidepressant Lexapro, made by Forest Laboratories Inc and known generically as escitalopram, could modestly ease anxiety symptoms in older adults. More than 164 million prescriptions were written in 2008 for antidepressants, totaling $9.6 billion in U.S. sales, according to IMS Health.