Loading...
Please wait, while we are loading the content...
Similar Documents
The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis
| Content Provider | Scilit |
|---|---|
| Author | Strawn, Jeffrey R. Mills, Jeffrey A. Sauley, Beau A. Welge, Jeffrey A. |
| Copyright Year | 2018 |
| Description | Journal: Journal of the American Academy of Child & Adolescent Psychiatry To determine the trajectory and magnitude of antidepressant response as well as the effect of antidepressant class and dose on symptomatic improvement in pediatric anxiety disorders. Weekly symptom severity data were extracted from randomized, parallel group, placebo-controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric anxiety disorders. Treatment response was modeled for the standardized change in continuous measures of anxiety using Bayesian updating. Posterior distributions for each study served as informative conjugate priors to update subsequent study posteriors. Change in symptom severity was evaluated as a function of time, class and, for SSRIs, standardized dose. Data from 9 trials (SSRIs: n=5; SSNRIs, n=4) evaluating 7 medications in 1,673 youth were included. In the logarithmic model of treatment response, statistically—but not clinically—significant treatment effects emerged within 2 weeks of beginning treatment (standardized medication-placebo difference = -0.054, CI: -0.076 to -0.032, p=0.005, approximate Cohen’s d ≤ 0.2) and by week 6, clinically significant differences emerged (standardized medication-placebo difference = -0.120, CI: -0.142, -0.097, p=0.001, approximate Cohen’s d = 0.44). Compared to SSNRIs, SSRIs resulted in significantly greater improvement by the second week of treatment (p=0.0268) and this advantage remained statistically significant through week 12 (all ps<0.03). Improvement occurred earlier with high dose SSRI treatment (week 2, p=0.002) compared to low-dose treatment (week 10, p=0.025), but SSRI dose did not impact overall response trajectory (p>0.18 for weeks 1-12). In pediatric patients with generalized, separation and/or social anxiety disorders, antidepressant-related improvement occurs early in the course of treatment and SSRIs are associated with more rapid and greater improvement compared to SSNRIs. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877120/pdf http://www.jaacap.com/article/S0890856718300534/pdf |
| ISSN | 08908567 |
| e-ISSN | 15275418 |
| DOI | 10.1016/j.jaac.2018.01.015 |
| Journal | Journal of the American Academy of Child & Adolescent Psychiatry |
| Issue Number | 4 |
| Volume Number | 57 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-02-07 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of the American Academy of Child & Adolescent Psychiatry Psychiatry and Mental Health Clinical Psychology Selective Serotonin Reuptake Inhibitor (ssri Selective Serotonin Norepinephrine Reuptake Inhibitor (ssnri Separation Anxiety Disorder (sad) Social Phobia (sop) Generalized Anxiety Disorder (gad) |
| Content Type | Text |
| Resource Type | Article |
| Subject | Developmental and Educational Psychology Psychiatry and Mental Health |
