FLUOXETINE FOR CHILDHOOD ANXIETY DISORDERS

Objective: The objective of this open study was to determine the effic acy and safety of fluoxetine for the treatment of children and adolesc ents with anxiety disorders. Method: Twenty-one patients with overanxi ous disorder, social phobia, or separation anxiety disorder, who were unresponsive to previous psychopharmacological and psychotherapeutic i nterventions, were treated openly with fluoxetine for up to 10 months. Patients with lifetime histories of obsessive-compulsive disorder (OC D) or panic disorder, or with current major depression, were excluded. Beneficial and adverse effects of fluoxetine were ascertained using t he improvement and severity subscales of the Clinical Global Impressio n Scale (CGIS) in two ways: (1) independent chart reviews by two child psychiatrists and (2) prospective assessments by the treating nurses and the patients' mothers. Results: Eighty-one percent (n = 17) of pat ients showed moderate to marked improvement in anxiety symptoms. The s everity of anxiety as measured by the CGIS was also significantly redu ced from marked to mild (effect size: 2.3). There were no significant side effects. Conclusions: These results suggest that fluoxetine may b e an effective and safe treatment for nondepressed children and adoles cents with anxiety disorders other than OCD and panic disorder. Future investigations using double-blind, placebo-controlled methodologies a re warranted.