Trial reportThe American journal of psychiatry2013
Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.
Trial report in The American journal of psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 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
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- The Impact of Development on Antidepressant and Placebo Response in Anxiety Disorders: A Bayesian Hierarchical Meta-Analytic Examination of Randomized Controlled Trials in Children, Adolescents, and Adults.Journal of child and adolescent psychopharmacology · 2024Pooled it
- Cognitive behavioural therapy and third-wave approaches for anxiety and related disorders in older people.The Cochrane database of systematic reviews · 2024Pooled it
- Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Long-Term Pharmacological Treatments of Anxiety Disorders: An Updated Systematic Review.Current psychiatry reports · 2016Pooled it
- 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
- Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults.Clinical gerontologistTrial
- A multi- and mixed-method adaptation study of a patient-centered perioperative mental health intervention bundle.BMC health services research · 2023Article
- A Patient-Centered Perioperative Mental Health Intervention Bundle: A Multi- and Mixed-Method Adaptation Study.Research square · 2023Article
- The pathophysiology and management of depression in cardiac surgery patients.Frontiers in psychiatry · 2023Review
- Article
- Valproate Adjuvant Cognitive Behavioral Therapy in Panic Disorder Patients With Comorbid Bipolar Disorder: Case Series and Review of the Literature.Psychiatry investigation · 2022Article
- Depressive symptom complexes of community-dwelling older adults: a latent network model.Molecular psychiatry · 2022Article
- Article
- Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert opinion on pharmacotherapy · 2018Review
- Pharmacological Management of Anxiety Disorders in the Elderly.Current treatment options in psychiatry · 2017Article
- Emotion Reactivity and Cerebrovascular Burden in Late-Life GAD: A Neuroimaging Study.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2016Article
- Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic.Journal of rehabilitation research and development · 2016Article
- Treatment-refractory anxiety; definition, risk factors, and treatment challenges.Dialogues in clinical neuroscience · 2015Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy.
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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.