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Pharmacotherapy for anxiety disorders in children and adolescents
Cochrane Reviews, 07/10/09

Ipser JC et al. - Medication treatments can be effective in paediatric anxiety disorders, acting to reduce core symptoms, and should be considered as part of the treatment of these disorders. The greatest number of trials showing efficacy to date have assessed the SSRIs in treating paediatric OCD.

Methods

Two raters independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality.
Investigators were contacted to obtain missing data.
Summary statistics were stratified by medication class, and by medication agent for the selective serotonin reuptake inhibitors (SSRIs).
Dichotomous and continuous measures were calculated using a random effects model, heterogeneity was assessed, and subgroup/sensitivity analyses were undertaken.

Results

22 short-term (<= 16 weeks) RCTs were included in the analysis (2519 participants).
Medication and placebo response occurred in 58.1% and 31.5% of patients, respectively (Number of studies (N) = 14, Number needed to treat (NNT) = 4).
Medication was more effective than placebo in reducing overall symptom severity in OCD in a post-hoc comparison (N = 7, Weighted Mean Difference (WMD) = -4.45, 95%CI = -5.94, -2.97, n = 765).
Medication was less well tolerated than placebo overall, though the absolute proportion of participants who withdrew due to drug-related adverse events was low (4.9%).

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