Medication treatment options for pediatric anxiety disorders
The mounting pressure of school and social stressors may lead to an increase in pediatric patients presenting to your care with anxiety. Cognitive Behavioral Therapy (CBT) treatment should be offered first for mild to moderate anxiety disorders. For moderate to severe anxiety disorders, The American Academy of Child and Adolescent Psychiatry (AACAP), recommends a combination of CBT and medication treatment as the most effective treatment for anxiety disorders (1). There are many validated measurement tools to assess anxiety severity (see resources below).
The first-line medication for the treatment of pediatric anxiety is a SSRI (2). Prozac, Lexapro, Celexa, and Zoloft have the best evidence for treating anxiety in children (see the table below for more information). If a child suffers from both Major Depressive Disorder and any type of anxiety disorder, first-line treatment differs a bit from treatment of anxiety disorders alone. In this case, recommended SSRIs for comorbid depressive and anxiety disorders include fluoxetine, citalopram, and escitalopram.
While these are some general guidelines in treating pediatric anxiety disorders, each case is nuanced. Illinois DocAssist is here to help you in your clinical decision-making and assist you in locating local treatment resources. Our psychiatrists and social workers are available for free consultation during normal business hours and can be reached at 866-986-2778 or by submitting an online consultation request.
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Anxiety Disorders: Parents’ Medication Guide: https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/med_guides/anxiety-parents-medication-guide.pdf
Anxiety Screening Tools for Primary Care: https://illinoisdocassist.uic.edu/provider-resources/screening-tools/
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1) JAACAP Practice Parameters Anxiety Disorders https://www.jaacap.org/article/S0890-8567(20)30280-X/fulltext
2) UpToDate Pharmacotherapy for anxiety disorders in children and adolescents: https://www.uptodate.com/contents/pharmacotherapy-for-anxiety-disorders-in-children-and-adolescents