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Posted: April 11, 2009 11:30 p.m.

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Anxiety in children: a look at treatment options

Not surprisingly, parents who have a child diagnosed with an anxiety disorder often struggle to choose the right treatment. They are frequently apprehensive, and rightly so, about the effects of psychotropic medication. They may discover that a good therapist can be hard to find and that the costs in terms of both time and money can be difficult to bear.

An article published in the Oct. 30, 2008, issue of “The New England Journal of Medicine’ helps clarify the relative value of various treatment options for anxiety disorders in children. A randomized, 12-week, controlled trial compared cognitive behavioral therapy, the antidepressant sertraline (Zoloft), the combination of the two, and placebo medication (basically a sugar pill with no medicinal value). Some 500 children with diagnosed anxiety disorders, ranging in age from 7 to 17, participated in the trial.

More than 80 percent of those receiving the combined therapy (CBT and Zoloft) experienced significant improvement, compared to 60 percent of those receiving only CBT and 55 percent of those receiving only Zoloft. Both solo treatments of CBT or Zoloft were more than twice as effective as placebo.

Children receiving Zoloft did report a higher number of mild adverse side effects such as sedation, sleeplessness and fidgeting. It is reassuring and important to note (given the highly publicized concerns about suicide risk), that no child attempted suicide. And, children taking Zoloft did not report suicidal or homicidal thoughts any more frequently than those in the “sugar pill” category, providing yet more reassurance that, with careful monitoring, medication as a treatment option is relatively safe.

The results supporting the benefits of combined treatment represent a boon for the almost 50 percent of children who do not get relief from medication or DBT alone. However, while the combination of medication and CBT achieved the most significant results, for parents who still experience apprehensions about medication, CBT is a good first option as an effective treatment for childhood anxiety disorders.
Peggy Nolen is a licensed professional counselor in Covington. She specializes in the treatment of depression, anxiety, problems with drugs and alcohol, and recovery from traumatic experience. She can be reached at (770) 314-5924.

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