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Cited by 3Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentTreatment of Major Depression

The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder

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Castagna, Peter J., Farahdel, Elita, Potenza, Marc N., Crowley, Michael J.·2023·Expert Opinion on Pharmacotherapy
DOI 10.1080/14656566.2023.2199921PMC PMC10197951
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Abstract

INTRODUCTION: Anxiety disorders are the most prevalent psychiatric disorders among youth. Among the various anxiety disorders, generalized anxiety disorder is particularly prevalent. Youth with GAD appear at elevated risk of developing other anxiety disorders, mood disorder, and substance use disorders. Functional outcomes of youth with GAD can be improved through early recognition and treatment, thus promoting better longer-term outcomes. AREAS COVERED: The current article summarizes evidence-based state-of-the-art pharmacotherapy for pediatric GAD based on open-label, randomized, and controlled trials. Two electronic databases (PubMed and Scopus) were systematically searched in April 2022 for relevant publications. EXPERT OPINION: The literature supports a combination of psychotherapy and pharmacotherapy as being associated with better outcomes when compared to mono-therapies. While longer-term follow-ups are limited, one such study does challenge this notion. Both selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) have been found across studies to have moderate effect sizes in the treatment of pediatric anxiety disorders. SSRIs continue to be a first-line intervention, whereas SNRIs may be considered a second-line treatment. While more evidence is needed, there are emerging data indicating that SSRIs are associated with a more rapid and greater reduction in anxiety symptoms when compared to SNRIs.

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  • Additional research suggests combining psychotherapy with pharmacotherapy yields better outcomes than either approach alone, as psychotherapy can teach skills in managing fear-inducing social situations while pharmacotherapy alleviates symptoms facilitating greater participation in behavioral interventions.

    “Additional research suggests that combining psychotherapy with pharmacotherapy yields better outcomes than either approach alone, as psychotherapy can teach valuable skills in managing fear-inducing social situations while pharmacotherapy alleviates symptoms facilitating greater participation in behavioral interventions [60,61].”

    From The risks versus the benefits of pharmacological intervention in social anxiety disorder in children (2025) · cites this paper as [61]

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  1. [75]Strawn,, A randomized, placebo-controlled study of duloxetine for the treatment of children and adolescents with generalized anxiety disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 2015. 54(4): p. 283– 293. 25791145

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Authors
Castagna, P. J., Farahdel, E., Potenza, M. N., & Crowley, M. J.
Affiliations
Yale University (US)
Corresponding author
Crowley, Michael J.
ORCID
Venue
Expert Opinion on Pharmacotherapy
Publisher
Informa UK Limited
Published
2023-04-19
Volume
24
Issue
7
Pages
835-847
ISSN
  • 1465-6566 (ISSN-L)
  • 1744-7666
DOI
10.1080/14656566.2023.2199921
PMC
PMC10197951
OpenAlex
W4366351355
Cited by
3
References
79
Citations by year
2025: 1 · 2023: 2
FWCI
0.13
Type
journal article
Language
en
Open access
Locations
  • Expert Opinion on Pharmacotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (F32 MH 124319)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
pharmacotherapy, selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, youth anxiety disorders, first-line and second-line treatment, treatment outcomes
MeSH terms
Serotonin and Noradrenaline Reuptake Inhibitors, Adolescent, Anxiety Disorders, Child, Humans, Selective Serotonin Reuptake Inhibitors

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