Alzheimer's: Medications for Treating Anxiety

Overview of using medications to treat anxiety in Alzheimer's patients.

Medications for treating anxiety

Anxiety symptoms are fairly common among patients with Alzheimer's Disease (AD). Such symptoms are likely to make patient care more problematic and, therefore, increase the risk of nursing home placement.

Anxiety states, accompanied by panic attacks and fearfulness, may lead to demands for constant company and reassurance.

Short-lived periods of anxiety, for example in response to a stressful event, may be helped by a group of drugs known as benzodiazepines. Continuous treatment in excess of two to four weeks is not advisable because dependency can occur, making it difficult to stop the medication without withdrawal symptoms.

One important thing to remember, benzodiazepines (like Xanax) can reduce anxiety, but they can also create more memory problems and increase the risk of falls since they slow reaction times and disrupt balance. SSRI antidepressant medications (Prozac, Lexapro), though, may help to reduce anxiety for some patients.

Side-effects of anti-anxiety medications

• There are many different benzodiazepines, some with a short duration of action, such as lorazepam and oxazepam, and some with longer action, such as chlordiazepoxide. All of these drugs may cause excessive sedation, unsteadiness and a tendency to fall, and they may accentuate any confusion and memory deficits that are already present.
• Major tranquilizers (antipsychotics) are often used for severe or persistent anxiety. If taken for long periods these drugs can produce a side-effect called tardive dyskinesia, which is recognized by persistent involuntary chewing movements and facial grimacing. This may be irreversible but is more likely to disappear if it is recognized early and the medication causing the problem stopped.

Sources:

• Anxiety Symptoms as Predictors of Nursing Home Placement in Patients with Alzheimer's Disease, Journal of Clinical Geropsychology, Volume 8, Number 4, October 2002.
• Haupt M, Karger A, Janner M. Improvement of agitation and anxiety in demented patients after psychoeducative group intervention with their caregivers. Int J Geriatr Psychiatry 2000;15:1125-9.
• Treatment of agitation in older persons with dementia. The Expert Consensus Panel for Agitation in Dementia. Postgrad Med 1998 Apr; Spec No:1-88.
• Alzheimer's Society - UK - Carers' advice sheet 408, March 2004