Drug-therapy combo best for anxiety in kids -study

CHICAGO Thu Oct 30, 2008 2:40pm EDT

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CHICAGO Oct 30 (Reuters) - A combination of a common antidepressant and a specialized form of talk therapy offer the best treatment for children and youth with anxiety disorders, U.S. researchers said on Thursday.

The findings come from the largest study of anxiety in children yet and offer much-needed guidance about how best to treat young people with separation anxiety, social phobia and generalized anxiety disorder -- conditions that affect as many as 20 percent of children and teenagers in the United States.

The study "clearly showed that combination treatment is the most effective for these children," Dr. John Walkup of Johns Hopkins University in Baltimore, who worked on the study, said in a statement.

But he said either therapy alone or sertraline alone helped well. Sertraline is the generic name of Pfizer Inc's (PFE.N) Zoloft, which is one of a class of antidepressants called selective serotonin reuptake inhibitors.

"This suggests that clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs," said Walkup, whose study appears in the New England Journal of Medicine.

The 12-week study involved 488 children aged 7 to 17 who took part in one of four treatment groups. One group took the drug Zoloft only. Another received 14 sessions of cognitive behavioral therapy, in which trained therapists teach children how to face and master their fears. A third group got both the drug and the therapy, while the fourth got only a sugar pill.

After 12 weeks, 81 percent of the children who got both drug and cognitive behavioral therapy, or CBT, improved, suggesting the combination worked best.

Sixty percent of the children who got cognitive therapy got better, and 55 percent in the sertraline-only group improved, while only 24 percent in the placebo group improved.

"It's the first time that we have tested the combination of CBT and medication. That's never been done in children," said Anne Marie Albano of the New York State Psychiatric Institute and Columbia University Medical Center.

The study is the first to show that CBT worked as well as drug therapy, she said.

"The other thing is the medication came out looking very safe in this population," Albano said in a telephone interview.

Albano said the findings help to clarify how best to treat young people with these common and often misunderstood disorders. "We are not talking here about normal fears all kids get," she said.

"We are talking about intractable anxiety and fear to the point that there is such distress that the child shrinks away from the world."

Because anxiety is an emotion all people share, anxiety disorders in children often go years without treatment, she said.

(Editing by Maggie Fox and Bill Trott)

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