Augmenting antidepressant medication with modular CBT for geriatric generalized anxiety disorder: a pilot study

International Journal of Geriatric Psychiatry - Tập 26 Số 8 - Trang 869-875 - 2011
Julie Loebach Wetherell1,2, Jill A. Stoddard3, Kamila S. White4, Sander J. Kornblith5, Hoang M. Nguyen1,2, Carmen Andreescu5, Sidney Zisook1,2, Eric J. Lenze6
1Department of Psychiatry, University of California San Diego, La Jolla, California, USA
2VA San Diego Healthcare System San Diego California USA
3Department of Psychology, Alliant International University, San Diego, California, USA
4Department of Psychology , University of Missouri , St. Louis , Missouri , USA
5Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
6Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA

Tóm tắt

AbstractObjectiveGeneralized anxiety disorder (GAD) is a prevalent psychiatric condition in older adults with deleterious effects on health and cognition. Although selective serotonin reuptake inhibitor (SSRI) medications have some efficacy as acute treatments for geriatric GAD, incomplete response is the most common outcome of monotherapy. We therefore developed a novel sequential treatment strategy, using personalized, modular cognitive‐behavioral therapy (mCBT) to augment SSRI medication.MethodIn an open label pilot study (N = 10), subjects received a sequenced trial of 12 weeks of escitalopram followed by 16 weeks of escitalopram augmented with mCBT. We also examined the maintenance effects of mCBT over a 28‐week follow‐up period following drug discontinuation and termination of psychotherapy.ResultsResults suggest that (1) adding mCBT to escitalopram significantly reduced anxiety symptoms and pathological worry, resulting in full remission for most patients and (2) some patients maintained response after all treatments were withdrawn.ConclusionFindings suggest that mCBT may be an effective augmentation strategy when added to SSRI medication and provide limited support for the long‐term benefit of mCBT after discontinuation of pharmacotherapy. Copyright © 2010 John Wiley & Sons, Ltd.

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International Journal of Geriatric Psychiatry

Tập 26 Số 8

869-875

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