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儿童和青少年焦虑症的药物治疗

Pharmacotherapy for anxiety disorders in children and adolescents.

作者信息

Kodish Ian, Rockhill Carol, Varley Chris

机构信息

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.

出版信息

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

Abstract

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.

摘要

焦虑症是青少年中最常见的心理健康诊断疾病,会带来持续功能损害以及成年后出现其他精神共病的风险。本文讨论了青少年焦虑症评估和治疗的注意事项,重点关注药物治疗的证据基础以及优化护理的重要临床考虑因素。然后,我们简要描述焦虑对恐惧回路神经元成分的影响,以突出治疗如何通过增强可塑性来改善功能损害。总体而言,焦虑症的药物治疗在改善临床症状方面是有效的,特别是与心理治疗相结合时。通常在几周内就能看到疗效,但纵向研究有限。选择性5-羟色胺再摄取抑制剂被认为对青少年几类焦虑症的急性治疗相对安全有效,越来越多的证据支持神经元可塑性在康复中的作用。

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