CLONAZEPAM IN CHILDHOOD ANXIETY DISORDERS

Objective: There is evidence for the efficacy and safety of clonazepam (CZP) in adult anxiety disorders, but no formal studies to substantia te clinical reports of similar benefit in children with anxiety disord ers. Method: In this double-blind pilot study, 15 children, aged 7 to 13 years, entered a randomly assigned, double-blind crossover trial of 4 weeks of CZP (up to 2 mg/day) and 4 weeks of placebo. Results: Twel ve children completed the trial. All but 1 had a diagnosis of separati on anxiety disorder, and all but 2 had comorbid diagnoses. Nine childr en appeared to have moderate to significant clinical improvement, but statistical comparisons on several ratings failed to confirm a trend i n favor of CZP. Side effects of drowsiness, irritability, and/or oppos itional behavior were notable in 10 children in the CZP phase compared with 5 in the placebo phase. Conclusions: Clonazepam was believed to have clinical benefit for some children, but this was not confirmed st atistically in this small sample. Problematic side effects of drowsine ss and disinhibition were common and possibly were due to rapid titrat ion.