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best drugs for anxiety in elderly with sleep problems

My mother is 80 and is on Cozaar (for blood pressure) and Pravastatin (for Cholesterol).  She is very agile for her age but has been having difficulty speaking, is anxious, sleeps very little and has recently had  some slight problems with gait.  Recent MRI found nothing remarkable.  I would like to know what you would recommend for anxiety that wouldnt keep her up. Ambien CR has not at all helped her to sleep.   A neurologist we only saw twice wants to put her on Lexapro for anxiety and wondered if there is something better?
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579483 tn?1259467903
Taking into consideration her age of eighty-years, and co-morbid factors of arterial hypertension and hyperlipidemia, my recommendation would be Ativan - 0.25 mg, q.h.s. initially, titrating the dosage upward in 0.25 mg increments as-needed and as- tolerated.

Ativan has no appreciable effect on liver function (unlike Lexapro), Ativan would not accumulate excessively in the elderly (unlike Klonopin or Valium), and Ativan would provide guaranteed relief. Lexapro may prove to be overly stimulating. Lexapro is better suited for anxiety that recurs secondary to a depressive affect.

Serax is another (weaker) option. Speak with the neurologist.
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Arlington, VA
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Arlington, WA
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