Anxiety: spectrum from response to a crisis → adjustment disorder → major anxiety disorder.

Ensure anxiety not secondary to lack of information or poor symptom control, especially pain or dyspnea.

Delirium can present with anxiety-like symptoms.



  • see section on depression management for choice of antidepressant. Mirtazepine best choice for frail elders.


  • only use regularly for severe ongoing anxiety in those not responsive to antidepressants: clonazepam
  • for acute short-acting anxiety/panic (temporary use until antidepressant onsets): lorazepam
  • in frail older adults: methotrimeprazine better than benzodiazepine due to risk of delirium with benzos

Pregabalin or Gabapentin

useful for anxiety with neuropathic pain, insomnia. Many side effects in frail elders.

Other therapies

  • supportive psychological and spiritual counselling
  • discussing and providing information about disease-progression and the dying process may relieve specific anxieties
  • avoid anxiety triggers
  • music therapy