Treatment for teen anxiety
Study shows a particular treatment for childhood anxiety disorders could
be beneficial

Date:
August 25, 2020
Source:
University of Cincinnati
Summary:
In a new study, researchers took a first look at one particular
medication for treatment of anxiety disorders in pediatric patients
to see if it was beneficial.



FULL STORY ========================================================================== Anxiety disorders are the most common mental illness in the U.S., with approximately 4.4 million children and adolescents affected, according
to the Centers for Disease Control and Prevention.


========================================================================== "These disorders are not only common in children and teens, but, if
untreated, result in considerable personal and economic cost over the lifetime," says Jeffrey Strawn, MD, associate professor and anxiety
expert in the Department of Psychiatry and Behavioral Neuroscience at
the University of Cincinnati.

In a new National Institute of Mental Health-funded study, led by Strawn
and published in the Journal of Clinical Psychiatry, UC researchers
took a first look at one particular medication for treatment of these
disorders in pediatric patients to see if it was beneficial.

"Psychotherapy and medications reduce symptoms for many children and adolescents with anxiety disorders," says the UC Health physician. "In particular, the selective serotonin reuptake inhibitors, or SSRIs, have
shown benefit in numerous trials." Strawn says SSRIs work by increasing serotonin in the brain. Serotonin is one of the chemical messengers that
nerve cells use to communicate with one another. These medications block
the reabsorption of serotonin into nerve cells, making more serotonin
available to improve transmission of messages between neurons.

"However, up to two in five children don't completely improve with
existing medication treatments," he says. "While SSRIs represent the
first line medication for anxious youth, predicting treatment response
is difficult.



========================================================================== "Improvement varies considerably from patient to patient, often
resulting in a trial-and-error process of medication selection and
dosing. Additionally, clinicians have limited data to help them to
determine which patients will respond to what treatments." "To help
predict which patients would improve most with one SSRI, called
escitalopram, my colleagues and I compared its use to a placebo in
adolescents with generalized anxiety disorder." Fifty-one patients aged
12-17 were randomly chosen to be treated with either escitalopram or a
placebo for eight weeks. Their anxiety symptoms and overall improvement
were evaluated in addition to how well they tolerated the medication. They
also had their blood drawn to assess how medication blood levels impacted
their outcomes.

"We found this particular SSRI to be superior to a placebo in reducing anxiety," Strawn says. "Also, differences in how adolescents break
down the medication affected blood levels, and these blood levels
predicted certain side effects, like restlessness, jitteriness and
insomnia. Understanding how blood levels vary could help us determine
dosage." Strawn and his collaborators also found that some patients
improved more quickly than others. Patients who were slower metabolizers
of the medication had better outcomes and improved faster when compared
to patients who had increased metabolism of the medication.

Strawn says this is the first controlled study of this SSRI for pediatric anxiety disorders and the first to assess the impact of metabolism on escitalopram blood levels in adolescents. He says a larger study with
a more diverse population is needed.

"For clinicians treating anxious adolescents, this study provides
preliminary answers to important questions about the effectiveness of
this treatment. It may also help clinicians predict how quickly patients respond and identify which patients may be less likely to get better. This would help us select alternative treatments for patients who are less
likely to respond," he says.

"We hope this will open the door for more studies and eventually become
a more effective treatment for patients in the future." Strawn's
collaborators include: Laura Ramsey, PhD, assistant professor in UC's Department of Pediatrics and a member of the Divisions of Clinical
Pharmacology and Research in Patient Services at Cincinnati Children's
Hospital Medical Center, and Jeffrey Mills, PhD, associate professor of economics at UC, The study was supported by the National Institute of
Mental Health, and genetic testing performed in this study was provided
by Myriad Genetics.


========================================================================== Story Source: Materials provided by University_of_Cincinnati. Original
written by Katie Pence. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jeffrey R. Strawn, Jeffrey A. Mills, Heidi Schroeder, Sarah
A. Mossman,
Sara T. Varney, Laura B. Ramsey, Ethan A. Poweleit, Zeruesenay
Desta, Kim Cecil, Melissa P. DelBello. Escitalopram in Adolescents
With Generalized Anxiety Disorder. The Journal of Clinical
Psychiatry, 2020; 81 (5) DOI: 10.4088/JCP.20m13396 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200825133130.htm

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