[Management of panic disorder in the elderly].
Gériatrie et Psychologie Neuropsychiatrie du Viellissement. 2020-09-01; 18(3): 295-304
DOI: 10.1684/pnv.2020.0878
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1. Geriatr Psychol Neuropsychiatr Vieil. 2020 Sep 1;18(3):295-304. doi:
10.1684/pnv.2020.0878.
[Management of panic disorder in the elderly].
[Article in French]
Pace M(1), Heckendorn M(1), Aouizerate B(2), Hanon C(1), Seigneurie AS(1),
Lavaud P(1), Hozer F(1), Pascal De Raykeer R(1), Guerin-Langlois C(1), Cormier
L(1), Poncelin De Raucourt H(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, 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, France, Inserm U1266, Institut
de psychiatrie et neurosciences de Paris ; Faculté de médecine Paris Descartes,
Université de Paris, France.
Panic disorder in the elderly is an understudied disorder, despite being
associated with substantial functional impairment, diminished quality of life
and increased suicide risk in this population. This disorder is likely to be
underdiagnosed and sometimes inadequately treated in the absence of national and
international guidelines for this vulnerable population. Few therapeutic trials
have specifically focused on the efficacy and tolerability of pharmacologic and
psychotherapy treatments for panic disorder in the elderly, and current
approaches to detect and manage this disorder are mainly based on experts’
opinion or extrapolation from data available in younger adults. This report aims
to provide a summary of current knowledge on pharmacologic 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,
like selective serotonin reuptake inhibitor (SSRI), restricted benzodiazepine
usage, take care of drug interactions, and importance of psychotherapy like
cognitive behavioral therapy (CBT).
DOI: 10.1684/pnv.2020.0878
PMID: 32759090 [Indexed for MEDLINE]