Antidepressant helps kids with social anxiety

A commonly used antidepressant appears to help kids with social anxiety disorder, which causes them to become extremely distressed by ordinary social situations, new research shows.

The investigators found that kids with the condition given paroxetine (Paxil) were 7 times more likely to experience an improvement after 16 weeks, compared to kids who were given an inactive placebo drug.

Moreover, nearly half of kids taking Paxil appeared to be “very much” improved, a change seen in only 15 percent of those given the placebo.

A little more than 5 percent of the children taking Paxil dropped out of the study, due to side effects from the drug, compared with just over 1 percent in the placebo group.

These findings suggest that Paxil is an “effective, generally well-tolerated” option for kids and teens with social anxiety disorder, write the authors, led by Dr. Karen Dineen Wagner of the University of Texas Medical Branch in Galveston.

The study was funded by GlaxoSmithKline Pharmaceuticals, which sells Paxil. Many of Wagner’s co-authors are either employees of or have received money from GlaxoSmithKline, according to disclosure statements accompanying the study in the Archives of General Psychiatry.

Recently, the U.S. Food and Drug Administration issued warnings that some children and teenagers with major depression thought about or attempted suicide in several clinical trials of antidepressants, including Paxil.

The FDA has subsequently ordered the makers of all antidepressants to include strong warnings explaining that the drugs increase the chances of suicidal behavior in some children and teens.

Social anxiety disorder (SAD) is marked by an excessive fear and avoidance of situations in which a person feels he or she will be judged by others - such as public speaking, or even eating in front of other people.

“Ordinary social interactions, such as starting or joining a conversation, and performances, such as playing sports or participating in dance recitals, cause significant distress for these children,” Wagner and her colleagues write.

Many kids with SAD become extremely lonely as a result, and fail to develop adequate social skills. Moreover, in young people, SAD can increase the risk of other problems, including depression, smoking, suicidal behavior and drug use. Some evidence suggests that the condition may persist into adulthood.

Previous research has shown that Paxil appeared to help adults with SAD. To investigate whether the same is true in children, Wagner and her colleagues followed 322 children and teens with SAD between the ages of 8 and 17 for 16 weeks. Some participants received Paxil, some a placebo.

During treatment, kids were assessed by trained mental health professionals to determine how they were responding.

More than three-quarters of Paxil-takers showed some improvement after 16 weeks, relative to around one-third of those on the placebo. Participants who took Paxil were also 4 times more likely to be in remission by the end of the study period than those given the placebo, the authors report.

On the downside, Paxil-takers were more likely to experience a side effect that required them to cut back on their medication. Common side effects included insomnia, sleepiness, nervousness and decreased appetite.

SOURCE: Archives of General Psychiatry, November 2004.

Provided by ArmMed Media
Revision date: July 8, 2011
Last revised: by Andrew G. Epstein, M.D.