Older Adults Using Lexapro for Generalized Anxiety

Generalized anxiety (GAD) is the most commonly diagnosed form of anxiety among adults. Symptoms of GAD include excessive worry or fear that interferes with daily life. For younger adults, a wealth of data exists showing the effectiveness and safety of Lexapro (escitalopram) in treating GAD. However, far less information exists regarding treatment outcomes for older adults.

Surveys indicate that at least 7% of adults in residential living centers undergo treatment for GAD. Those living on their own may experience GAD at an even greater rate. The elderly population as a whole experiences mood problems at a disproportionately higher rate. In addition, the elderly often have comorbid conditions such as dementia or major depression. For these reasons and others, elderly individuals with GAD often respond poorly to treatment. A study published in the Journal of the American Medical Association shed light on the question of whether Lexapro is a good choice for older adults, but still there are more questions than answers.

Study authors recruited 177 subjects aged 60 years or older with confirmed diagnoses of GAD. Approximately half of the participants received a 12-week treatment with Lexapro, while the remainder received placebo. A variety of psychological tests were administered to gauge response to the treatment. Self-reporting also weighed heavily in the final results.

Because adverse effects represent a potentially more serious concern among older adults, vital signs were taken at regular intervals. At the end of the 12-week study, the Lexapro group showed significant improvement in GAD symptoms. Side effects were mostly minor and included fatigue and sleep disturbances. Regular checks of vital signs confirmed that Lexapro caused no cardiac anomalies for any of the participants.

Among the interesting findings from this study is the observation that Lexapro only separated itself from placebo at week 4. This finding highlights the fact that adherence to a treatment regimen is an essential, but sometimes neglected, component of generating benefits for the individual. Geriatric individuals are in fact more likely to miss doses or stop taking medication entirely, especially if 2 or 3 weeks pass with no changes to their anxiety. Add to this circumstance the fact that elderly people often have additional diagnoses and decreased cognitive functioning, and this population becomes far more at risk.. Primary care physicians must be sure to emphasize the slow-acting nature of Lexapro as they screen the elderly for anxiety problems.


  1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Escitalopram. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000214/
  2. Jenze, E. J., Rollman, B. L., Shear, M. K., Dew, M. A., Pollock, B. G., Ciliberti, C., Constantino, M. (2009). Escitalopram for older adults with generalized anxiety disorder: a randomized controlled trial. Journal of the American Medical Association, 301(3), 295-303.

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  • Rick

    January 13th, 2020 at 10:49 AM

    Lexapro worked great with my 92 year old mother for several months. She was extremely active after the 4 weeks but later had less energy than before. Also was fearful of the most minor things. We are probably going to take her off of the drug.

  • Leila

    September 16th, 2020 at 8:52 PM

    The doctor has prescribed 10 mg. of Lexapro for my 94 year old mom. Did you end up taking your mom off of it? Thanks for sharing,

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