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    Childhood Anxiety Found Best Treated With Both Drugs, Therapy

    sang_garuda
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    Post by sang_garuda Fri Oct 31, 2008 6:41 pm

    Children suffering from separation anxiety, social phobia and generalized anxiety disorders benefit most when treated with both Pfizer Inc.'s antidepressant Zoloft and psychotherapy targeting behavior, researchers said.

    Although each method alone is effective, the combination works best, according to the study published online today in the New England Journal of Medicine. The study, funded by the U.S. government, also found no instances of attempted suicide, a ``rare'' side effect of antidepressants in children.

    Anxiety is one of the most common mental disorders among youths, and the research is the first and largest comparing treatments for childhood anxiety. Anxiety, marked by excess worry and fear, can cause physical distress and keep children from making friends and doing well in school.

    ``This study provides strong evidence and reassurance to parents that a well-designed, two-pronged treatment approach is the gold standard, while a single line of treatment is still effective,'' said Thomas R. Insel, director of the National Institute of Mental Health, the U.S. agency that sponsored the research, in a statement today. Pfizer supplied the drugs.

    The study results also add more evidence that high-quality behavioral therapy with or without medication can treat anxiety in children, the researchers said.

    ``Clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs,'' said lead investigator John Walkup from Johns Hopkins Hospital in Baltimore, in the statement.

    488 Children

    Researchers at six locations, among them the Columbia University in New York and the University of Pittsburgh Medical Center, assigned 488 children between 7 and 17 years to one of four treatment choices for three months. The children received behavioral therapy; sertraline, which Pfizer sells as Zoloft; a placebo pill; or a combination of sertraline with behavioral therapy. Pfizer supplied the drugs and placebo.

    Among those receiving combination treatment, 81 percent improved, compared with 60 percent for those undergoing behavioral therapy only, and 55 percent taking only sertraline.

    Almost a quarter of patients taking placebo improved. The researchers will monitor the children for an additional six months.

    Children taking sertraline alone showed no more side effects than those taking the placebo, suggesting the medicine is safe. Few children stopped participation in the trial due to side effects, and no child attempted suicide.

    Facing Their Fears

    The cognitive behavioral therapy used taught children about anxiety and helped them face and master their fears by guiding them through structured tasks.

    The study may also help predict which patient would respond best to which treatment, so that we may be able to develop more personalized therapies for children with anxiety, said Philip Kendall from Temple University near Philadelphia. ``But in the meantime, we can be assured that we already have good treatments at our disposal.''

    The results were also being presented at the American Academy of Child & Adolescent Psychiatry's annual meeting in Chicago.

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