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Review: pharmacotherapy increases response and reduces symptom severity in paediatric anxiety disorders

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What is the efficacy and tolerability of pharmacotherapy for paediatric anxiety disorders?


Response (score of 1 or 2 (much or very much improved) on the Clinical Global Impressions-Improvement scale); symptom severity or investigator defined response on closely related measures; symptom severity (clinician rated DSM based anxiety scales such as the Child Yale-Brown Obsessive-Compulsive Scale); adverse events.



Systematic review and meta-analysis.

Data sources:

Cochrane Depression, Anxiety and Neurosis Group specialised register (CCDANCTR-Studies), MEDLINE (from 1966), EMBASE (from 1966) and PsycINFO (from 1972) were searched in August 2008. Reference lists of retrieved articles were hand searched; ongoing and unpublished studies were identified through electronic registers and contact with experts.

Study selection and analysis:

Placebo controlled randomised controlled trials (RCTs) of pharmacotherapy in children and adolescents (aged <18 years) with primary diagnoses of anxiety disorders (DSM-III or later). Studies where participants were receiving psychotherapy or pharmacotherapy for secondary psychiatric disorders were excluded. Authors were contacted if required. Two reviewers decided on the inclusion of studies. Meta-analyses were stratified by drug class and also by individual selective serotonin reuptake inhibitors (SSRIs). Random effects models were used for meta-analyses, and heterogeneity assessed using the χ2 test and I2 statistic. …

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  • Sources of funding University of Cape Town, and MRC Research Unit on Anxiety and Stress Disorders, South Africa.


  • Competing interests JTW and SC received free drug and placebo from Pfizer for the NIMH funded Child/Adolescent Anxiety Multimodal Study. JTW also received free drug and placebo from Eli Lilly for the NIMH funded Treatment of Adolescents with Depression Study.

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