Certain antidepressants more effective in treating youth anxiety disorder, analysis shows

March 19, 2018 by Alison Sampson, University of Cincinnati Academic Health Center

For children and adolescents who require medication to treat anxiety, there are two primary classes of antidepressants that are prescribed: selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs).

Now, University of Cincinnati (UC) research, published online ahead of the April issue of the Journal of the American Academy of Child and Adolescent Psychiatry shows for the first time that SSRIs may be the more effective option.

"For a long time there had been this sense that SSRIs work better than the SNRIs in treating anxious youth, but there wasn't clear evidence to back this up, so we wanted to put that notion to the test," says Jeffrey Strawn, MD, associate professor in the Department of Psychiatry and Behavioral Neuroscience at the UC of Cincinnati College of Medicine, and lead author on the study.

"What we found is that with the SSRIs, compared to SNRIs, people get better faster and see greater improvement overall. There had been some suggestion of this in some individual studies, but this is the first to evaluate the magnitude and trajectory of treatment, or in other words, how much and how quickly people get better."

For the meta-analysis, UC researchers compiled the data from nine . Strawn partnered with Jeffrey Welge, PhD, research associate professor of psychiatry, and econometricians Jeffrey Mills and Beau Sauley at the Lindner College of Business who created a model to examine two things: how quickly the patients got better and by how much.

The models showed that patients started to see improvements from around two weeks, with the more significant improvement occurring in the fourth week of treatment. Strawn says it was also important to look at to find out whether the dose of the medication affected improvement.

"We saw that [dosage] didn't necessarily affect how much the patients improve, but it did affect how quickly they get better," says Strawn, indicating that a higher dosage helped this.

Jeffrey Mills, PhD, an associate professor in the Department of Economics at the Lindner College of Business, and Sauley, a doctoral student, used statistical analysis common in economic modeling to apply it to the clinical data.

"We have very complementary skill sets, so interdisciplinary research of this nature is a great example of work that could not be accomplished by any one author," says Mills. "Everyone's contributions results in more robust research that none of us would be able to produce alone."

Mills' particular expertise is in Bayesian statistical inference and modeling. "As an econometrician, I have mostly applied these tools to analyzing economic data, so it is refreshing and exciting to get to apply my expertise to a different field like psychopharmacology," he says.

Strawn says one significant aspect of this study lies in the fact that it may be immediately applicable to clinical practice.

"In research, many findings impact our work in the clinic years down the road, but this type of work potentially changes how we select medications to treat children and adolescents with anxiety disorders today," he adds.

Explore further: CBT, SSRIs effectively cut anxiety symptoms in childhood

More information: Jeffrey R. Strawn et al, The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis, Journal of the American Academy of Child & Adolescent Psychiatry (2018). DOI: 10.1016/j.jaac.2018.01.015

Related Stories

CBT, SSRIs effectively cut anxiety symptoms in childhood

September 5, 2017
(HealthDay)—Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are effective for reducing symptoms of anxiety in childhood, according to a review published online Aug. 31 in JAMA Pediatrics.

New study on the placebo effect and antidepressants in children and adolescents

September 15, 2017
Although the clinical efficacy of antidepressants in children and adolescents is proven, it is frequently accompanied by side effects. In addition, the influence of the placebo effect on the efficacy of antidepressants is ...

Study explores a novel candidate for antidepressant treatment

January 17, 2018
According to the World Health Organization more than three hundred million people worldwide are affected by major depressive disorder. Unfortunately, the antidepressants commonly used to treat them only work for 50% of the ...

Study focuses on atomic structure of the serotonin transporter bound to SSRIs

January 29, 2018
New molecular research shows how chemically diverse drugs used to treat depression and anxiety disorders interact with the protein that transports serotonin in the brain. The discovery by researchers at the OHSU Vollum Institute ...

Opioid cessation may be more successful when depression is treated

February 5, 2018
Opioid cessation in non-cancer pain may be more successful when depression is treated to remission, a Saint Louis University study shows.

Patients' expectations influence effectiveness of SSRI antidepressants

October 3, 2017
Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety but their superiority over placebo has been questioned, generating considerable debate among researchers and clinicians. In ...

Recommended for you

Three-minute version of brain stimulation therapy effective for hard-to-treat depression

April 26, 2018
In the largest study of its kind, a three-minute version of a brain stimulation treatment was shown to be just as effective as the standard 37-minute version for hard-to-treat depression.

Unprecedented study identifies 44 genetic risk factors for major depression

April 26, 2018
A global research project has mapped out the genetic basis of major depression, identifying 44 genetic variants which are risk factors for depression, 30 of which are newly discovered. The study, by the Psychiatric Genomics ...

Millennial men value altruism and self-care above traditional male qualities

April 25, 2018
Contrary to popular stereotypes, young men today are likely to be selfless, socially engaged and health-conscious, according to a new study from the University of British Columbia and Intensions Consulting, a Vancouver-based ...

Indications of psychosis appear in cortical folding

April 25, 2018
Imaging techniques can be used to detect the development of psychosis in the brains of high-risk patients at an early stage, as reported by researchers from the University of Basel and Western University in the journal JAMA ...

Maternal binge drinking linked to mood problems and alcohol abuse in offspring

April 25, 2018
Binge drinking by pregnant and lactating mothers can impair the mental health of their offspring, reports a study published today in Frontiers in Psychiatry. In a rat model, Italian researchers find that while habitual drinking ...

Engaging in physical activity decreases people's chance of developing depression

April 24, 2018
An international team including researchers from King's College London have found physical activity can protect against the emergence of depression, regardless of age and geographical region.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.