Management of panic disorder in the elderly.
Geriatr Psychol Neuropsychiatr Vieil .. 2021-10-05; :
DOI: 10.1684/pnv.2021.0965
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Pace M(1), Heckendorn M(1), Aouizerate B(2), Hanon C(1), Seigneurie AS(1),
Lavaud P(1), Hozer F(1), Raykeer RP(1), Guerin-Langlois C(1), Cormier L(1),
Raucourt HP(1), Limosin F(3), Hoertel N(3).
Author information:
(1)Centre ressource régional de psychiatrie du sujet âgé (CRRPSA), Service de
psychiatrie et d’addictologie de l’adulte et du sujet âgé, DMU psychiatrie et
addictologie, AP-HP Centre-Université de Paris, Paris, France.
(2)Pôle de psychiatrie générale et universitaire, Centre de référence régional
des pathologies anxieuses et de la dépression (Centre expert dépression
résistante, fondation FondaMental), CH Charles Perrens, Bordeaux, Laboratoire
nutrition et neurobiologie intégrée (UMR INRA 1286), Université de Bordeaux,
Bordeaux, France.
(3)Centre ressource régional de psychiatrie du sujet âgé (CRRPSA), Service de
psychiatrie et d’addictologie de l’adulte et du sujet âgé, DMU psychiatrie et
addictologie, AP-HP Centre-Université de Paris, Paris, France, Inserm U1266,
Institut de psychiatrie et neurosciences de Paris ; Faculté de médecine Paris
Descartes, Université de Paris, Paris, France.
Panic disorder in the elderly is an understudied disorder, despite being
associated with substantial functional impairment, a diminished quality of life
and an increased suicide risk in this population. This disorder is likely to be
underdiagnosed and sometimes inadequately treated due to the absence of national
and international guidelines for this vulnerable population. Few therapeutic
trials have specifically focused on the efficacy and tolerability of
pharmacological and psychotherapy treatments for panic disorder in the elderly
and current approaches to detect and manage this disorder are mainly based on
expert opinions or extrapolation from data available on younger adults. This
report aims to provide a summary of current knowledge on pharmacological and
psychotherapeutic treatments for panic disorder in the elderly and to propose a
medical treatment algorithm, which should be viewed as a tool that may
contribute to the choice of treatment, especially for treatment-resistant older
patients with panic disorder. The main results here are the emphasis on
antidepressant treatment, such as selective serotonin reuptake inhibitor (SSRI),
restricted benzodiazepine usage, awareness of drug interactions and the
importance of psychotherapy such as cognitive behavioural therapy (CBT).
DOI: 10.1684/pnv.2021.0965
PMID: 34612816