The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
January 1, 2023
C Bree Johnston, Maria Mangini, Charles Grob et al.
33 citations
Psychedelics such as psilocybin and MDMA show promise for treating mood disorders, PTSD, prolonged grief, and psychological distress from serious illness in older adults, and may aid dementia patients or promote personal growth in healthy seniors. Both compounds act on the 5HT2A receptor and can be safely given to healthy adults under controlled conditions, but they raise blood pressure and heart rate, posing risks for older adults with cardiovascular disease. Few older adults or those with multiple health conditions have been included in clinical trials, limiting generalizability. More research is needed on safety and efficacy in this population.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
November 1, 2022
Noah Berens, Scott Yh Kim
12 citations
Depression is common in terminally ill patients and can influence requests for physician-assisted death (PAD), but clinicians struggle to assess its role. A case series showed that rapid treatment with intranasal ketamine clarified whether depression was driving the PAD request: one patient withdrew her request after realizing it was depression-driven, while others maintained theirs. Other emerging rapid treatments, such as psilocybin with support and transcranial magnetic stimulation, raise ethical issues. These include using such treatments to evaluate decision-making capacity, tensions between legal definitions of irremediability and clinicians' ethical duties, and obstacles to treatment access that may undermine equal respect for patient autonomy.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
October 1, 2023
Stacey Hatch, Marcia Finlayson, Soham Rej et al.
5 citations
A randomized controlled trial tested whether video-delivered Emotion Focused Mindfulness Therapy (EFMT) could reduce anxiety in adults aged 55 and older. Forty-eight participants were assigned to group EFMT via Zoom or a wait-list control. Recruitment took 32 weeks, with 62.3% of screened individuals enrolling; retention was 80.0% and adherence among the intervention group was 100.0%. At 9 weeks, the EFMT group showed a greater reduction in anxiety scores (−3.47 points) compared to the control group (−1.22 points), a statistically significant difference. The findings suggest that virtually-delivered EFMT is feasible, acceptable, and effective for late-life anxiety.