Research: Specialized talk therapy and antidepressants help children and teens

Philip Copitch, Ph.D. ~ Author of Change: How to bring real change to your life: The psychology and secrets of highly effective people

A specialized mental health treatment called, cognitive behavioral therapy (CBT) has been clinically shown, many times over the last few years, to help patients deal with common diagnoses such as depression, anxiety disorders, and panic disorders.

CBT is a form of talk therapy that teaches patients how to challenge negative patterns of thought, about themselves and their world; thoughts that often lead them to self-destructive decisions and behaviors.

This research looked at how CBT worked by itself, and with mental health medication, for childhood anxiety disorders.

The medications were:

Selective Serotonin Reuptake Inhibitors (SSRIs), are a class of antidepressants that work by increasing levels of serotonin (a neurotransmitter) in the brain. SSRIs slow how quickly the brain picks up serotonin from between the nerve synapsis, thus leaving more available for the nerves to use.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), is a class of antidepressants that work by increasing levels of serotonin and norepinephrine (neurotransmitters) in the brain. SNRIs slow how quickly the brain picks up serotonin and norepinephrine from between the nerve synapsis, thus leaving more available for the nerves to use. SNRIs affect a wider range of neurotransmitters and are often used with multiple types of mood disorders.

Size of the study and its findings

•This meta-analysis looked at data from 7,719 patients in 115 studies. 4290 (55.6%) were female, and the mean (range) age was 9.2 (5.4-16.1) years. A meta-analysis statistically analyzes data from multiple studies.

•When SSRIs were compared to placebo pills, this study found that SSRIs significantly reduced anxiety in patients.

•Patients in this study taking Benzodiazepines and tricyclics (Older forms of anti-anxiety medication, tranquilizers.)

•Concerning CBT the researchers wrote:

When CBT was compared with wait-listing/no treatment, CBT significantly improved primary anxiety symptoms, remission, and response. Cognitive behavioral therapy reduced primary anxiety symptoms more than fluoxetine and improved remission more than sertraline. The combination of sertraline and CBT significantly reduced clinician-reported primary anxiety symptoms and response more than either treatment alone.

•It was noted that medication had some negative side effects while CBT did not:

Adverse events were common with medications, but not with CBT, and were not severe. Studies were too small or too short to assess suicidality with SSRIs or SNRIs. One trial showed a statistically nonsignificant increase in suicidal ideation with venlafaxine [antidepressant brand name Effexor XR].

• Cognitive behavioral therapy had fewer patient dropouts than placebo pills or medications.

Read the research paper

Citation: Wang Z, Whiteside SPH, Sim L, Farah W, Morrow AS, Alsawas M, Barrionuevo P, Tello M, Asi N, Beuschel B, Daraz L, Almasri J, Zaiem F, Larrea-Mantilla L, Ponce OJ, LeBlanc A, Prokop LJ, Murad MH. Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety DisordersA Systematic Review and Meta-analysis. JAMA Pediatr. Published online August 31, 2017. doi:10.1001/jamapediatrics.2017.3036

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