An evidence-based approach to treating pediatric anxiety disorders
Current Psychiatry. 2012 September;11(09):16-21
September 1, 2012|Psychiatry
Author and Disclosure Information
Research supports SSRIs, other medications as part of a multimodal approach
GAD: generalized anxiety disorder; RUPP: Research Unit on Pediatric Psychopharmacology; SAD: separation anxiety disorder; SNRI: serotonin-norepinephrine reuptake inhibitor; SoP: social phobia; SSRI: selective serotonin reuptake inhibitorTable
Practical dosing of SSRIs and SNRIs in pediatric patients with anxietya
| Medication | Initial child dose (age <12; mg/d) | Initial adolescent dose (age 12 to 17; mg/d) | Target dose (mg/d) |
|---|---|---|---|
| Citalopram | 5 to 10 | 10 | 20 to 40 |
| Escitalopram | 2.5 to 5 | 5 to 10 | 10 to 20 |
| Fluoxetineb | 10 | 20 | 20 to 40 (children), 40 to 60 (adolescents) |
| Paroxetineb | 5 to 10 | 10 | 20 |
| Sertralinec | 10 to 12.5 | 25 | 150 |
| Venlafaxine | 37.5 | 37.5 | 150 |
| aGeneralized anxiety disorder, social phobia, and separation anxiety disorder bMay consider cytochrome P450 genotyping for 2D6, which may suggest an alternate dosing strategy cSertraline is available in a liquid formulation (20 mg/mL) SNRI: serotonin-norepinephrine reuptake inhibitor; SSRI: selective serotonin reuptake inhibitor Source: Adapted from reference 34 | |||
Related Resources
- Connolly SD, Bernstein GA; Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007;46(2):267-283.
- Anxiety and Depression Association of America. www.adaa.org.
- American Academy of Child & Adolescent Psychiatry. www.aacap.org.
Drug Brand Names
- Alprazolam • Xanax
- Atomoxetine • Strattera
- Buspirone • BuSpar
- Citalopram • Celexa
- Clonazepam • Klonopin
- Fluoxetine • Prozac
- Fluvoxamine • Luvox, Luvox CR
- Lorazepam • Ativan
- Paroxetine • Paxil, Paxil CR
- Sertraline • Zoloft
- Venlafaxine • Effexor, Effexor XR
Disclosures
Dr. Strawn has received research support from the American Academy of Child & Adolescent Psychiatry, Eli Lilly and Company, and Shire, and is an employee of the University of Cincinnati, Cincinnati, OH.
Dr. McReynolds was employed by Eli Lilly and Company from 1997 to 2005.
