Fluoxetine for the treatment of childhood anxiety disorders.
OBJECTIVE
To assess the efficacy and tolerability of fluoxetine for the acute treatment of children and adolescents with generalized anxiety disorder, separation anxiety disorder, and/or social phobia.


METHODS
Anxious youths (7-17 years old) who had significant functional impairment were randomized to fluoxetine (20 mg/day) (n = 37) or placebo (n = 37) for 12 weeks.


RESULTS
Fluoxetine was effective in reducing the anxiety symptoms and improving functioning in all measures. Using intent-to-treat analysis, 61% of patients taking fluoxetine and 35% taking placebo showed much to very much improvement. Despite this improvement, a substantial group of patients remained symptomatic. Fluoxetine was well tolerated except for mild and transient headaches and gastrointestinal side effects. Youths with social phobia and generalized anxiety disorder responded better to fluoxetine than placebo, but only social phobia moderated the clinical and functional response. Severity of the anxiety at intake and positive family history for anxiety predicted poorer functioning at the end of the study.


CONCLUSIONS
Fluoxetine is useful and well tolerated for the acute treatment of anxious youths. Investigations regarding the optimization of treatment to obtain full anxiety remission and the length of treatment necessary to prevent recurrences are warranted.
Birmaher
Boris
B
Department of Child Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. birmaherb@msx.upmc.edu.
Axelson
David A
DA
Monk
Kelly
K
Kalas
Catherine
C
Clark
Duncan B
DB
Ehmann
Mary
M
Bridge
Jeffery
J
Heo
Jungeun
J
Brent
David A
DA
D000293:Adolescent; D001008:Anxiety Disorders / Q000188:drug therapy*; D002648:Child; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors