Trial reportThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2011
Elevated cortisol in older adults with generalized anxiety disorder is reduced by treatment: a placebo-controlled evaluation of escitalopram.
Trial report in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Candidate Biological Markers for Social Anxiety Disorder: A Systematic Review.International journal of molecular sciences · 2023Pooled it
- Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2016Pooled it
- Dose-Dependent Acute Effects of Everolimus Administration on Immunological, Neuroendocrine and Psychological Parameters in Healthy Men.Clinical and translational science · 2020Trial
- An exploratory study of salivary cortisol changes during chamomile extract therapy of moderate to severe generalized anxiety disorder.Journal of psychiatric research · 2018Trial
- Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial.Journal of consulting and clinical psychology · 2016Trial
- Emotion reactivity and regulation in late-life generalized anxiety disorder: functional connectivity at baseline and post-treatment.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2015Trial
- Antiglucocorticoid therapy for older adults with anxiety and co-occurring cognitive dysfunction: results from a pilot study with mifepristone.International journal of geriatric psychiatry · 2014Trial
- Effect of paroxetine on physiological response to stress and smoking.Psychosomatic medicine · 2013Trial
- Treatment-related alteration of cortisol predicts change in neuropsychological function during acute treatment of late-life anxiety disorder.International journal of geriatric psychiatry · 2012Trial
- A pilot randomized, single-blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause.Menopause (New York, N.Y.) · 2012Trial
- Generalized anxiety disorder, psychiatric comorbidities, and suicide.Social psychiatry and psychiatric epidemiology · 2026Article
- Sex Differences in the Ventral Subiculum's Microcircuitry and Function.Hippocampus · 2026Review
- Obstetric Complications and Pregnancy Outcomes in Cancer Survivors: A Systematic Review and Meta-Analysis.Cancers · 2025Review
- The cortisol axis and psychiatric disorders: an updated review.Pharmacological reports : PR · 2025Review
- Attachment orientation and platelet activity.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Article
- Article
- Association Between Extreme Heat and Outpatient Visits for Mental Disorders: A Time-Series Analysis in Guangzhou, China.GeoHealth · 2024Article
- Article
- A comparative study on hair cortisol concentration among generalized anxiety disorder patients with and without alcohol dependence syndrome presenting to a tertiary care center: A pilot study.Indian journal of psychiatry · 2024Article
- Effects of antidepressant on FKBP51 mRNA expression and neuroendocrine hormones in patients with panic disorder.BMC psychiatry · 2024Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundGeneralized anxiety disorder (GAD) is a common disorder in older adults, which has been linked to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in this age group. The authors examined whether treatment of GAD in older adults with a selective serotonin reuptake inhibitor (SSRI) corrects this HPA axis hyperactivity.
methodsThe authors examined adults aged 60 years and older with GAD in a 12-week randomized controlled trial comparing the SSRI escitalopram with placebo. The authors collected salivary cortisol at six daily time points for 2 consecutive days to assess peak and total (area under the curve) cortisol, both at baseline and posttreatment.
resultsCompared with placebo-treated patients, SSRI-treated patients had a significantly greater reduction in both peak and total cortisol. This reduction in cortisol was limited to patients with elevated (above the median) baseline cortisol, in whom SSRI-treated patients showed substantially greater reduction in cortisol than did placebo-treated patients. Reductions in cortisol were associated with improvements in anxiety. Additionally, genetic variability at the serotonin transporter promoter predicted cortisol changes.
conclusionsSSRI treatment of GAD in older adults reduces HPA axis hyperactivity. Further research should determine whether these treatment-attributable changes are sustained and beneficial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.