Geriatric Psychiatrist Questions Anxiety

My mother is 80 years old and has severe anxiety. Should she really be on xanex?

Because of the effects of xanex, I'm not sure if my mother should be on it any more. But I know that she suffers from severe anxiety, always did. Should we keep her on it? If not, what else would you recommend?

4 Answers

Hi. Medications such as Xanax and others in its class are contraindicated in the elderly but there is a small group of people for whom other options do not work well. The best alternative might be an antidepressant such as Lexapro and gradually tapering off the Xanax. I would strongly recommend she be fully evaluated by a geriatrically trained psychiatrist before doing anything. Thanks.
Good question.
If she has been taking it for a long time and if it helps her anxiety and she has no side effects, she should stay on.
Xanax (alprazolam) can be risky in the elderly. I wouldn't stop it abruptly, though, as there are serious withdrawal consequences. There are better medications for anxiety, but she should see a psychiatrist, preferably a geriatric psychiatrist, to safely transition her to another medication. Psychotherapy may also be helpful.
She should be slowly tapered off Xanax which is already impairing her memory. She should NOT be placed on any other benzodiazepine. Alternative medications could be selected after evaluating her history and what other meds she has taken for treatment of anxiety and any medical problems she may have and current concomitant medications. Possible alternatives include Cymbalta, Lexapro, Neurontin (all for preventing chronic anxiety) or "rescue, non-addictive medications" which start to work in 20 minutes, full effect in 2 hours and last 6-12 hours, including Vistaril, Atarax and Inderal. There are certainly other alternatives, depending other history