Some factors shown to increase anxiety include very high levels of social contact, dysfunctional patient-caregiver relationships, and high physical dependency. Other factors that can negatively impact anxiety in older adults include boredom, social isolation, and unmet physical needs for proper nutrition, warmth, and cleanliness, for example. Pharmacologic treatment options for those with panic disorder can include a short course of benzodiazepines and long-term SSRIs or SNRIs. Cognitive behavioral therapy has proven to be a particularly effective nonpharmacologic approach to treatment of anxiety and panic. As-needed medications for anxiety can be helpful in the initial weeks of treatment as the therapeutic effect of SSRIs and SNRIs is approached. Useful medications for as-needed treatment of anxiety include low-dose trazodone (25 or 50mg every 4-6 hours as needed). Other options might include gabapentin, mirtazapine, or low-dose propranolol.