CHICAGO Oct 30 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
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
(Editing by Maggie Fox and Bill Trott)