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Review
. 2011;13(4):439-52.
doi: 10.31887/DCNS.2011.13.4/ikodish.

Pharmacotherapy for anxiety disorders in children and adolescents

Ian Kodish  1 , Carol Rockhill, Chris Varley
Affiliations
Review

Pharmacotherapy for anxiety disorders in children and adolescents

Ian Kodish et al. Dialogues Clin Neurosci. 2011.

Abstract
in English, Spanish, French

Anxiety disorders are the most common mental health diagnoses in youth, and carry risks for ongoing impairments and subsequent development of other psychiatric comorbidities into adulthood. This article discusses considerations for assessment and treatment of anxiety disorders in youth, with a focus on the evidence base of pharmacologic treatment and important clinical considerations to optimize care. We then briefly describe the impact of anxiety on neuronal elements of fear circuitry to highlight how treatments may ameliorate impairments through enhanced plasticity Overall, pharmacotherapy for anxiety disorders is effective in improving clinical symptoms, particularly in combination with psychotherapy. Response is typically seen within several weeks, yet longitudinal studies are limited. Selective serotonin reuptake inhibitors are thought to be relatively safe and effective for acute treatment of several classes of anxiety disorders in youth, with increasing evidence supporting the role of neuronal plasticity in recovery.

Los trastornos ansiosos son los diagnósticos más comunes de salud mental en los jóvenes y conllevan riesgos de permanente deterioro y posterior desarrollo de otras comorbilidades en la adultez. En este artículo se discuten los aspectos a tener en cuenta para la evaluación y tratamiento de los trastornos ansiosos en la juventud focalizándose en los fundamentos para la evidencia del tratamiento farmacológico y en importantes consideraciones clínicas para optimizar el manejo. Además se describe brevemente el impacto de la ansiedad en los elementos neurales del circuíto del miedo y se destaca cómo los tratamientos pueden disminuir los deterioros al mejorar la plasticidad. En general la farmacoterapia de los trastornos ansiosos es efectiva en la mejoría de los sintomas clínicos, especialmente en combinación con la psicoterapia, Típicamente la respuesta se observa en algunas semanas, aunque los estudios longitudinales son limitados. Se cree que los inhibidores selectivos de la recaptura de serotonina son relativamente seguros y efectivos para el tratamiento agudo de diversas clases de trastornos ansiosos en la juventud, y hay evidencias crecientes que dan sustento al papel de la plasticidad neuronal en la recuperación.

Le diagnostic des troubles anxieux est le diagnostic de santé mentale le plus courant chez les jeunes; il comporte des risques de détériorations permanentes et de développement ultérieur d'autres comorbidités psychiatriques à l'âge adulte. Cet article analyse les critères d'évaluation et de traitement des troubles anxieux chez les jeunes, et il insiste sur la pertinence du traitement pharmacologique et sur certains aspects cliniques importants pour optimiser les soins. Nous décrivons ensuite brièvement l'impact de l'anxiété sur les éléments neuronaux du circuit de la peur pour souligner comment les traitements peuvent améliorer les troubles par une augmentation de la plasticité. De manière générale, le traitement pharmacologique des troubles anxieux améliore les symptômes cliniques, en particulier en association avec une psychothérapie, La réponse intervient généralement sous plusieurs semaines, mais les études longitudinales restent encore limitées. Les inhibiteurs sélectifs de la recapture de la sérotonine sont relativement sûrs et efficaces pour le traitement aigu de plusieurs types de troubles anxieux chez les jeunes, avec de plus en plus d'arguments en faveur du rôle de la plasticité neuronale dans la guérison.

Keywords: anxiety disorder; child; plasticity; pharmacotherapy; selective serotonin reuptake inhibitor.

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