Anxiety Disorders: FDA Approved Medications For Pediatric Anxiety

When it comes to treating anxiety in children, the array of available medications can be overwhelming. It is important to understand that some medications, like antidepressants, may be prescribed for anxiety.

Antidepressants could increase serotonin levels in the brain, which might regulate mood and anxiety. These medications could directly target anxiety symptoms and may also focus on alleviating the physical manifestations of anxiety.

Pediatric anxiety may cause excessive worrying, nervousness, obsessing, and general anxiety. Understanding how each medication works can aid in finding the most suitable treatment approach for pediatric anxiety.

Types Of Medication Used For Anxiety

1. Benzodiazepines

   Benzodiazepine medications may provide quick relief for specific anxiety-inducing situations, such as medical procedures or flying, by reducing physical symptoms like rapid heartbeat and sweating.

   Benzodiazepines like Ativan (lorazepam) and Klonopin (clonazepam) can offer immediate relief for acute anxiety episodes in children. They may serve as a temporary solution to alleviate anxiety until the effects of an antidepressant medication become noticeable.

   However, due to the potential risk of withdrawal symptoms and dependence, benzodiazepines are not advisable for long-term use in children.

2. Antipsychotics

   The antipsychotics most commonly prescribed for anxious youth include Risperdal (risperidone), Abilify (aripiprazole), and Seroquel (quetiapine). These medications are often paired with antidepressants, particularly in cases of Obsessive-Compulsive Disorder (OCD), as they can help reduce obsessive thoughts and rigidity in thinking.

   Here is a table outlining the common antipsychotics used for pediatric anxiety:

   Antipsychotic	Common Brand Name
   Risperidone	Risperdal
   Aripiprazole	Abilify
   Quetiapine	Seroquel

   However, it is essential to use them cautiously due to potential serious side effects like weight gain, metabolic abnormalities, neurological changes, and hormonal imbalances. Higher doses can worsen side effects, and the risk varies among different medications.

3. Antidepressants SNRIs

   SNRIs (serotonin-norepinephrine reuptake inhibitors) may offer an alternative treatment approach by targeting the levels of both serotonin and norepinephrine in the brain.

   SNRIs are commonly prescribed for child and adolescent anxiety, with medications such as Effexor XR (venlafaxine ER) and Cymbalta (duloxetine) being frequently used in clinical practice.

   SNRIs	Commonly Prescribed for Child and Adolescent Anxiety
   Effexor XR (venlafaxine ER)	Frequently used as a choice after SSRIs if the initial treatment is ineffective.
   Cymbalta (duloxetine)	Prescribed when there is a positive family history of SNRI response.

   Though SNRIs can be effective in managing anxiety, they may have a slightly higher rate of side effects compared to other antidepressants. Some common side effects of SNRIs include nausea, drowsiness, headache, and changes in appetite or weight.

4. Antihistamines

   Antihistamines, medications commonly utilized for reducing allergic reactions, are also recommended by some clinicians for temporarily alleviating anxiety in children.

   These medications could address the symptoms of anxiety by blocking the receptors of histamine in the central nervous system, leading to increased serotonin levels and a sedative effect, which can help in calming highly anxious children.

   • Benadryl (diphenhydramine): It is a well-known antihistamine that may help reduce anxiety symptoms in children.
   • Atarax and Vistaril (hydroxyzine): These antihistamines could be prescribed by clinicians to alleviate anxiety in pediatric patients.

   It is essential to be aware of potential side effects that may occur when using antihistamines for anxiety, such as drowsiness, dizziness, and dry mouth.

5. Antidepressants SSRIs

   Antidepressants such as Zoloft (sertraline), Prozac (fluoxetine), Luvox (fluvoxamine), Paxil (paroxetine), Celexa (citalopram), and Lexapro (escitalopram), work by boosting serotonin levels in brain, a neurotransmitter essential for regulating mood.

   SSRIs have been extensively studied and shown to alleviate anxiety symptoms in children and teenagers effectively. They may have fewer and milder side effects, making them more tolerable for pediatric patients.

6. Alpha Agonists

   Alpha agonists, like clonidine and guanfacine, are commonly prescribed to reduce symptoms of anxiety in children and adolescents. These medications could modulate the body's fight-or-flight response by acting on the sympathetic nervous system.

   Initially developed to lower high blood pressure in adults, these medications were later found to alleviate anxiety symptoms by reducing the sensitivity of the body's alarm system.

   Specifically, the alpha agonists prescribed for anxiety in young people are Catapres and Kapvay (clonidine), as well as Tenex and Intuniv (guanfacine).

   Some families opt for these medications over antidepressants due to concerns related to the black box warning associated with antidepressants, which highlights an increased risk of suicidality.

   However, it's important to note the potential side effects of clonidine and guanfacine, including dizziness, sleepiness, headache, dry mouth, loss of appetite, nausea, stomach pain, and vomiting.

7. Atypical Anxiolytics

   Atypical anxiolytics, such as Buspirone (Buspar), could provide a promising alternative for pediatric anxiety treatment due to their low risk of dependence and fewer side effects compared to benzodiazepines.

   Buspar claims to work by activating specific brain receptors to balance neurotransmitters, making it suitable for longer-term use while being less effective at immediately reducing anxiety symptoms.

   Side effects of atypical anxiolytics like buspirone include:

   • Sedation
   • Spaciness or confusion
   • Disinhibition
   • Dizziness

Role Of Medication

Medication may help children manage their symptoms and get comfortable enough to engage in therapy effectively. It could help in keeping children more relaxed, which reduces their frequency of anxiety breakouts.

Role of Medication	Details
Aid in Anxiety Management	Medication can assist children in managing their anxiety symptoms, allowing them to participate more effectively in cognitive behavioral therapy.
Complementary to CBT	When used alongside CBT, medication can enhance the overall treatment efficacy, providing a comprehensive approach to addressing anxiety in children.
Initial Treatment for Severe Anxiety	For severe cases, starting medication concurrently with therapy or even before can help alleviate symptoms and facilitate the therapeutic process.

Also See:

• Separation Anxiety Disorder Diagnosis and Treatment in Children & Adults
• 11 Best Strategies For Immediate Anxiety Relief

Frequently Asked Questions

1. Can Dietary Changes or Supplements Be Used as Alternative Treatments for Pediatric Anxiety Instead of Medication?
   Dietary changes and supplements may complement traditional treatments for pediatric anxiety. Though not a standalone replacement for medication, a balanced diet rich in magnesium and omega-3 fatty acids can support mental health. Consulting health experts is vital.
2. How Do Doctors Determine the Appropriate Dosage of Medication for Children With Anxiety?
   Doctors could determine appropriate medication dosages by considering factors like age, weight, severity of symptoms, and individual response. They start with low doses, closely monitor effectiveness and side effects, and adjust gradually for optimal treatment outcomes.
3. Are There Any Long-Term Effects of Using Medication to Treat Pediatric Anxiety?
   Long-term effects of using medication may include monitoring growth, possible impacts on brain development, and any emerging side effects. Regular evaluation by healthcare experts is essential to ensure optimal treatment outcomes.
4. What Are the Risks of Stopping Medication Abruptly for Pediatric Anxiety?
   Abruptly stopping medication could lead to withdrawal symptoms, relapse of anxiety, and potential worsening of mental health. Always consult a doctor before making any changes in medication to ensure a safe and effective treatment plan.
5. How Can Parents and Caregivers Support Children Who Are Taking Medication for Anxiety?
   Supporting children taking anxiety medication may involve understanding their needs, fostering open communication, monitoring for side effects, encouraging adherence, and collaborating with doctors.

Conclusion

FDA-approved medications for pediatric anxiety, such as antidepressants, antipsychotics, and atypical anxiolytics, may help in managing anxiety symptoms in children.

It is also essential to be aware of the side effects of these medications, as being aware helps parents stay calm when any side effects occur.

Understand your child's needs and talk openly with the doctor regarding your child's anxiety triggers, stress, and other reasons that increase his anxiety severity.

You can help your child manage his anxiety by providing a safe, nurturing environment, validating their feelings, and promoting healthy coping strategies are essential.

Combining medication with Cognitive Behavioral Therapy may provide a holistic approach to addressing anxiety in children effectively.