Skip to main content
Journal cover image

Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis.

Publication ,  Journal Article
Strawn, JR; Welge, JA; Wehry, AM; Keeshin, B; Rynn, MA
Published in: Depress Anxiety
March 2015

BACKGROUND: Randomized controlled trials have demonstrated that antidepressants are efficacious in the treatment of anxiety disorders in youth. However, there are no recent, systematic analyses of the efficacy, safety, or tolerability of these medications in pediatric anxiety disorders. METHODS: A systematic review and meta-analysis of prospective, randomized, parallel-group, controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric patients with non-obsessive compulsive disorder (OCD) anxiety disorders was undertaken using a search of PubMed/Medline (1966-2014). The meta-analysis utilized random-effects models to evaluate change in the Pediatric Anxiety Rating Scale or similar anxiety scale, suicidality, and adverse events. Additionally, pharmacologic variables were explored with regard to effect size, although no correction for multiple comparisons was made with regard to these relationships. RESULTS: Nine trials involving 1,673 patients and six medications were included. All SSRI/SSNRIs evaluated demonstrated efficacy, and the meta-analytic estimate of effect was of moderate magnitude (Cohen's d = 0.62, confidence interval [CI]: 0.34-0.89, P = .009) and there was evidence of modest heterogeneity (I(2) = 0.29, P = .103). Activation trended toward being more likely with antidepressant treatment (OR: 1.86, CI: 0.98-3.53, P = .054), but no increased risk was observed for nausea/abdominal symptoms (P = .262), discontinuation as a result of an adverse event (P = .132), or suicidality (OR: 1.3, CI: 0.53-3.2, P = .514). Finally, the effect size correlated with the serotonergic specificity of the agent (R = .79, P = .021). CONCLUSIONS: Data for nine SSRI/SSNRIs suggest superiority of antidepressants relative to placebo for the treatment of pediatric anxiety disorders with a moderate effect size.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

March 2015

Volume

32

Issue

3

Start / End Page

149 / 157

Location

United States

Related Subject Headings

  • Suicidal Ideation
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Selective Serotonin Reuptake Inhibitors
  • Randomized Controlled Trials as Topic
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Humans
  • Child
  • Anxiety Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Strawn, J. R., Welge, J. A., Wehry, A. M., Keeshin, B., & Rynn, M. A. (2015). Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety, 32(3), 149–157. https://doi.org/10.1002/da.22329
Strawn, Jeffrey R., Jeffrey A. Welge, Anna M. Wehry, Brooks Keeshin, and Moira A. Rynn. “Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis.Depress Anxiety 32, no. 3 (March 2015): 149–57. https://doi.org/10.1002/da.22329.
Strawn JR, Welge JA, Wehry AM, Keeshin B, Rynn MA. Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety. 2015 Mar;32(3):149–57.
Strawn, Jeffrey R., et al. “Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis.Depress Anxiety, vol. 32, no. 3, Mar. 2015, pp. 149–57. Pubmed, doi:10.1002/da.22329.
Strawn JR, Welge JA, Wehry AM, Keeshin B, Rynn MA. Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety. 2015 Mar;32(3):149–157.
Journal cover image

Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

March 2015

Volume

32

Issue

3

Start / End Page

149 / 157

Location

United States

Related Subject Headings

  • Suicidal Ideation
  • Serotonin and Noradrenaline Reuptake Inhibitors
  • Selective Serotonin Reuptake Inhibitors
  • Randomized Controlled Trials as Topic
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Humans
  • Child
  • Anxiety Disorders