Fluoxetine for the treatment of childhood anxiety disorders
Fluoxetine for the treatment of childhood anxiety disorders
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DOI：
10.1097/01.chi.0000037049.04952.9f
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发表时间：
2003-04-01
影响因子：
13.3
通讯作者：
Brent, DA
中科院分区：
文献类型：
--
作者：
Birmaher, B;Axelson, DA;Brent, DA
目的：评价氟西汀急性治疗儿童和青少年广泛性焦虑障碍、分离焦虑障碍和/或社交恐惧症的疗效和耐受性。方法：7-17岁有明显功能障碍的焦虑青少年（n = 37）随机接受氟西汀（20 mg/天）或安慰剂（n = 37）治疗12周。结果：氟西汀在减轻焦虑症状和改善功能方面均有效。使用意向治疗分析，61%的氟西汀患者和35%的安慰剂患者表现出很大或非常大的改善。尽管有所改善，但仍有相当一部分患者仍有症状。氟西汀耐受性良好，除了轻微和短暂的头痛和胃肠道副作用。患有社交恐惧症和广泛性焦虑障碍的青少年对氟西汀的反应优于安慰剂，但只有社交恐惧症减缓了临床和功能反应。摄入时焦虑的严重程度和积极的焦虑家族史预示着研究结束时功能较差。结论：氟西汀是治疗青少年焦虑症的有效药物，且耐受性良好。关于优化治疗以获得完全的焦虑缓解和预防复发所需的治疗时间的调查是必要的。
Objective: To assess the efficacy and tolerability of fluoxetine for the acute treatment of children and adolescents with generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Method: Anxious youths (7-17 years old) who had significant functional impairment were randomized to fluoxetine (20 mg/day) (n = 37) or placebo (n = 37) for 12 weeks. Results: Fluoxetine was effective in reducing the anxiety symptoms and improving functioning in all measures. Using intent-to-treat analysis, 61% of patients taking fluoxetine and 35% taking placebo showed much to very much improvement. Despite this improvement, a substantial group of patients remained symptomatic. Fluoxetine was well tolerated except for mild and transient headaches and gastrointestinal side effects. Youths with social phobia and generalized anxiety disorder responded better to fluoxetine than placebo, but only social phobia moderated the clinical and functional response. Severity of the anxiety at intake and positive family history for anxiety predicted poorer functioning at the end of the study. Conclusions: Fluoxetine is useful and well tolerated for the acute treatment of anxious youths. Investigations regarding the optimization of treatment to obtain full anxiety remission and the length of treatment necessary to prevent recurrences are warranted.