Seidel Laura, Walkup John T
Sheppard-Enoch Pratt Hospital, Baltimore, Maryland 21287, USA.
J Child Adolesc Psychopharmacol. 2006 Feb-Apr;16(1-2):171-9. doi: 10.1089/cap.2006.16.171.
The non-OCD (obsessive-compulsive disorder) anxiety disorders in the pediatric population- separation anxiety disorder, generalized anxiety disorder, and social phobia and others- are arguably the most common psychiatric disorders in this age group. Anxiety disorders, in addition to being common, also significantly impair the affected child at home, school, and with peers. A small developing evidence base suggests the selective serotonin reuptake inhibitors (SSRIs) are the pharmacological treatment of choice for pediatric non-OCD anxiety disorders. In clinical trials, SSRIs are often very effective in reducing symptoms and improving functioning and generally well tolerated. The U.S. Food and Drug Administration's (FDA) review of the safety of antidepressants in the pediatric population suggest a small, but significant, increased relative risk for suicidality adverse events on antidepressant versus placebo. Despite the apparent increased risk, the larger magnitude of benefit of the SSRIs for pediatric non-OCD anxiety disorders compared to depression suggests the benefit/risk ratio for anxiety disorders is more favorable than that for depression. This paper will review available studies on the treatment of non-OCD childhood anxiety disorders with antidepressants, including the SSRIs, and discuss pertinent safety issues.
儿科人群中的非强迫症焦虑症——分离焦虑症、广泛性焦虑症、社交恐惧症等——可以说是该年龄组中最常见的精神疾病。焦虑症不仅常见，还会在家庭、学校以及与同伴相处时对患病儿童造成显著影响。越来越多的证据表明，选择性5-羟色胺再摄取抑制剂（SSRI）是治疗儿科非强迫症焦虑症的首选药物。在临床试验中，SSRI通常在减轻症状、改善功能方面非常有效，而且总体耐受性良好。美国食品药品监督管理局（FDA）对儿科人群使用抗抑郁药安全性的审查表明，与安慰剂相比，服用抗抑郁药出现自杀性不良事件的相对风险虽小但显著增加。尽管风险明显增加，但与治疗抑郁症相比，SSRI对儿科非强迫症焦虑症的益处更大，这表明焦虑症的获益/风险比优于抑郁症。本文将综述有关使用包括SSRI在内的抗抑郁药治疗儿童非强迫症焦虑症的现有研究，并讨论相关的安全问题。
