Approximately 20 percent of elderly persons experience anxiety severe enough to warrant treatment, including medication. The Anxiety Disorders Association of America indicates that “anxiety is as common in the old as in the young…”
Because the elderly also have additional medical conditions and take more medications (prescription, over-the-counter and herbal supplements) than younger anxiety sufferers, they are at a higher risk for complications due to anxiety medications, for example:
Drug interactions - Anti-anxiety medications, such as Xanax or Valium, rarely lead to fatal overdose when used alone. However, these types of medications can be dangerous or fatal when combined with painkillers, sleeping pills or alcohol. Combining these medications with antidepressants can cause severe interactions. Even over-the-counter medications, such as antihistamines (found in many cold and allergy medications) can cause dangerous interactions when combined with anxiety medications.
Overdosing - Older adults metabolize medications slower than younger adults. The functions of both the liver and kidneys slow down, possibly causing a build-up of medication in the body. Overdosing can occur even when older adults take medication as prescribed. Doctors must pay attention to determine if dosage should be lowered as a patient ages. In addition, the elderly have a higher risk of forgetting they took their medication and taking it again.
Unintentionally skipping doses - Antidepressants and other similar medications work best when taken on a regular basis. Skipping medications can create or increase anxiety. Older adults may be at risk for forgetting to take medication.
Sensitivity to medications - Older adults can be more sensitive to medication, especially to those that cause drowsiness or have sedating effects. These medications can cause confusion, loss of balance and cognitive impairment. These types of effects are sometimes misdiagnosed as dementia. Anti-anxiety medications can cause drowsiness and poor coordination and have been linked to falling down, broken hips or legs and an increased risk of having a car accident.
In addition, side-effects of some medications can mistakenly be thought to be a new illness. For example, anti-anxiety medications can cause confusion and be diagnosed as dementia. Other medications, such as blood pressure medication, can cause side effects that may appear to be depression. Rather than lowering doses or discontinuing medications, doctors may misdiagnose and prescribe even more medication.
Some tips to help manage medication in the elderly:
Make sure doctors are aware of all current medications, this includes prescription medications, over-the-counter medications, herbal supplements and vitamins. Ask your doctor to review medications on a regular basis, including side effects and possible interactions.
When new symptoms appear, discuss the possibility of the symptoms being caused by or a side effect of medications.
Always ask about the possible side effects of new medications. Be aware if medications cause drowsiness or dizziness and do not drive until you are sure of your reaction to a medication.
Make sure you eat right and exercise each day (talk with your doctor before beginning an exercise program) to help counter act some of the effects of the medication.
Clarify how and when you are to take prescription medication, including whether medication should be taken with or without food, how many times per day and how long you should continue the medication to be sure you understand the dosing instructions.
Use a 7 day medication case to avoid missing doses or taking more medication than prescribed.
“Mental Health Medications”, Reviewed 2010, Feb 24, Author Unknown, National Institute of Mental Health
“Anxiety Medication”, Modified 2008, Sept, Melinda Smith, M.A., Jeanne Segal, Ph.D., Helpguide.org
“Older Adults”, Date Unknown, Anxiety Disorders Association of America