Antidepressants Effective and Safe in Older Adults with Anxiety

A systematic review and meta-analysis evaluated randomized controlled trials on pharmacological treatments for anxiety in adults aged 60 and older, identifying 19 eligible studies with 2,336 participants (68% women). The primary outcomes included reductions in anxiety symptoms, treatment response, or remission. Antidepressants were found to be more effective than placebo or waitlist controls in reducing anxiety symptoms (standardized mean differences –1.19), with moderate certainty of evidence despite high heterogeneity. They were also more effective in achieving treatment response or remission (risk ratio 1.52), though this evidence had low certainty and low heterogeneity. Subgroup analysis showed that selective serotonin reuptake inhibitors led to greater symptom reduction than serotonin–norepinephrine reuptake inhibitors, though no difference was observed in response or remission rates. Evidence for benzodiazepines was very uncertain and marked by high risk of bias. Other drug classes could not be adequately analyzed. Overall, antidepressants appear effective and reasonably safe for treating anxiety in older adults, while evidence for benzodiazepines remains weak, helping inform evidence-based clinical practice. Anxiety is common in older adults. Source: https://www.thelancet.com/