New developments in pharmacotherapy of pediatric anxiety disorders.
Anxiety disorders affect about 10% of children and adolescents, are often chronic and impair psychological, academic and social functioning. Recent studies have clearly demonstrated the efficacy of selective serotonin reuptake inhibitors in young people with obsessive-compulsive disorder and mixed or generalized anxiety disorders. Evidence is emerging for effectiveness in social phobia and its variant, selective mutism. Since the effect size for selective serotonin reuptake inhibitors in anxiety greatly exceeds that in depression, studies with small numbers readily show superiority of medication over placebo. Hence, further positive studies are predicted in the next few years. As a result, the rate of prescription of selective serotonin reuptake inhibitors in young people has been rising and will continue to do so. These medications are well-tolerated, but motor and behavioral side effects are more common in young people. Long-term research and postmarketing surveillance are needed.
Garland
E Jane
EJ
Department of Psychiatry, University of British Columbia, Mood and Anxiety Disorders Clinic, British Columbia's Children's Hospital, C429-4480 Oak Street, Vancouver, BC, Canada V6H 3V4. jgarland@cw.bc.ca