Psychopharmacologic Treatment of Pediatric Anxiety Disorders

ArticleinChild and Adolescent Psychiatric Clinics of North America 14(4):877-908, x · November 2005with12 Reads
Impact Factor: 2.60 · DOI: 10.1016/j.chc.2005.06.004 · Source: PubMed
Abstract

This article reviews the psychopharmacologic treatment of child and adolescent anxiety disorders and is divided into the following sections: historical background, general treatment principles, obsessive-compulsive disorder, other anxiety disorders, including separation anxiety disorders, generalized anxiety disorder, and social phobia, elective mutism, and post-traumatic stress disorder and specific phobia. Short-term and long-term psychopharmacologic treatment strategies are reviewed, as are approaches for managing comorbidity and treatment-refractory cases. This article is organized by diagnostic categories rather than by medication classes to emphasize the clinical perspective.

    • "Neuropharmacologically , there are both similarities and major differences between serotonin, dopamine, glutamate, opiate and other peptides and GABA systems. Many of these studies also reveal neurobiological differences between OCD and related OC behaviors (Pauls et al, 2002; Reinblatt et al, 2006; Waslick, 2006). These observationsmay explain the contributions made by overlapping but dysfunctional neurobiological mechanisms that underlie OCD and OCSD-the disruption in the convergence of social-emotional perceptual processing and the cross-talk between multiple neuronal networks involved in integrating and responding to this input. "
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    • "Clomipramine or Anafranil was the first serotonin reuptake inhibitor researched for the treatment of childhood OCD and the only TCA with an FDA indication for pediatric OCD . It is especially useful for children and adolescents who do not tolerate SSRIs ( Reinblatt and Walkup 2005 ; Green 1997 ) . As shown in Table 2 , Clomipramine has been reported to be efficacious in three randomized trials ( DeVeaugh - Geiss et al . "
    [Show abstract] [Hide abstract] ABSTRACT: Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and academic function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and increasing empirical evidence helps guide current clinical practice. To review studies which examine the pharmacological treatment of pediatric anxiety disorders, including obsessive-compulsive disorder and to summarize treatment implications. All relevant studies were searched using MEDLINE and PsycINFO search engines, supplemented by a manual bibliographical search; studies published between 1985 and 2006 that met inclusion criteria were examined. This article provides a systematic review of the psychopharmacological treatment of pediatric anxiety disorders based on available empirical evidence, with a focus on randomized controlled trials. General treatment principles and pharmacological management of specific pediatric anxiety disorders are also reviewed. There is good evidence to support the efficacy of several pharmacological agents including the selective serotonin reuptake inhibitors to treat pediatric anxiety and obsessive-compulsive disorder, although there are still many unanswered questions.
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