Table 4

Pharmacological treatment descriptions and evaluation findings

Medication
[daily dose]*
(diagnoses)
Sample size
(country)
AgesDurationChild anxiety outcomes (diagnostic rates)†Child
adverse events
D-cycloserine
[50 mg]
(SP)w52
37
(Australia)
6–14 yearsSingle dose↓ 2 of 2 symptoms‡Headache 39%; left study due to adverse events 0%
Fluvoxamine
[50–300 mg]
(SoP, SpAD, GAD)w53
128
(USA)
6–17 years2 months↓ 2 of 2 symptomsAbdominal discomfort 49%§; headache 43%; left study due to adverse events 8%
Fluoxetine I¶
[40 mg]
(SAD)w54
139
(USA)
7–17 years3 months↓ SAD diagnoses (79% vs 97%)
↓ 4 of 8 symptoms
Nausea % NR§; left study due to adverse events 0%
Fluoxetine II
[10–20 mg]
(GAD, SoP, SpAD)w55
74
(USA)
7–17 years3 months↓ 1 of 6 symptomsAbdominal pain or nausea 46%§; drowsiness 44%§; headaches 14%§; left study due to adverse events 14%
Fluoxetine III¶
[10–60 mg]
(SoP, GAD, SpAD)w56
62
(Australia)
11–16 years6 months• AD diagnoses (68% vs 77%)
• 4 of 4 symptoms
Left study due to adverse events 5%
Imipramine I
[100–200 mg]
(NR)** w57
42
(USA)
6–14 years1.5 months↓ 8 of 8 symptomsDrowsiness 62%; dry mouth 50%§; constipation 31%; dizziness 25%; left study due to adverse events % NR
Imipramine II
[75–275 mg]
(SpAD)w58
21
(USA)
6–15 years1.5 months• 29 of 29 symptoms††Dry mouth 46%; irritability 27%; changes in ECG % NR§; left study due to adverse events 0%
Paroxetine
[10–50 mg]
(SAD)w59
322
(USA, South Africa, Canada Belgium)
8–17 years4 months↓ 6 of 6 symptomsInsomnia 14%§; left study due to adverse events 6%
Sertraline I
[50 mg]
(GAD)w60
22
(USA)
5–17 years2.25 months↓ 6 of 7 symptomsDrowsiness 73%; dry mouth 55%; restlessness 55%; leg spasms 36%; left study due to adverse events 0%
Sertraline II¶
[25–200 mg]
(SpAD, GAD, SoP)w61
488
(USA)
7–17 years3 months↓ 2 of 4 symptoms
NR 2 of 4 symptoms
Insomnia 8%; fatigue 6%; sedation 5%; restlessness 4%; fever 1%‡‡; left study due to adverse events 6%
Venlafaxine
[37.5–225 mg]
(SAD)w62
293
(USA)
8–18 years4 months↓ 2 of 2 symptomsNausea 23%§; anorexia 22%§; weakness or loss of energy 20%§; sore throat 19%§; weight loss 11%§; dilated pupils 4%§; abnormal behaviour 4%§; heart rate increase % NR§; PR interval decrease % NR§; pulse rate increase % NR§; blood pressure increase % NR§; left study due to adverse events 4%
  • ↓ Denotes statistically-significant reductions in symptoms favouring medication over placebo.

  • • Denotes medication did not show statistically-significant benefit over placebo.

  • * Reported doses include widest range that children received at point therapeutic dose achieved; dosing is not equivalent across medications.

  • † Diagnostic rates for medication versus placebo.

  • ‡ Assessed 1 week after medication was administered.

  • § Adverse event(s) experienced by significantly more children on medication than placebo.

  • ¶ Medication was also compared with a psychosocial treatment, as described in text

  • ** All participating children were refusing to attend school or were doing so with marked distressed.

  • †† One outcome favoured placebo over medication.

  • ‡‡ All adverse events were experienced by significantly more children on sertraline than children participating in cognitive-behavioural therapy.

  • AD, anxiety disorder; ECG, electrocardiogram; GAD, generalised anxiety disorder; NR, not reported; PD, panic disorder; SAD, social anxiety disorder; SoP, social phobia; SP, specific phobia; SpAD, Separation anxiety disorder.