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Evidence summaries

Pharmacotherapy for Anxiety Disorders in Children and Adolescents

Medication treatments appear to be effective in childhood and adolescent anxiety disorders. The majority of trials contributing evidence of efficacy have been done with the SSRIs. There is insufficient data on long-term outcomes. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 22 studies with a total of 2 519 subjects. All studies were short-term (<= 16 weeks). The majority of the trials assessed the efficacy of the SSRIs (N = 15). Medication and placebo response occurred in 58.1% and 31.5% of patients, respectively (N =14 studies, NNT = 4). Medication was more effective than placebo in reducing overall symptom severity in OCD in a post-hoc comparison (WMD = -4.45, 95% CI -5.94 to -2.97, n = 765, 7 studies). Medication was less well tolerated than placebo overall, though the absolute proportion of participants who withdrew due to drug-related adverse events was low (4.9%).

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment, inadequate follow up).

    References

    • Ipser JC, Stein DJ, Hawkridge S, Hoppe L. Pharmacotherapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev 2009 Jul 8;(3):CD005170. [PubMed]

Primary/Secondary Keywords