As the recognition of paediatric and adolescent
anxiety disorders improves, so does the number of recommended treatments. Newer medications (chiefly serotonergic
antidepressants) have emerged as the pharmacological treatment of choice and have largely replaced
benzodiazepines and
tricyclic antidepressants (TCAs) for these disorders. This review will focus on placebo-controlled and open-label studies concerning the treatment of anxiety in children and adolescents, comparing data from newer
antidepressant medications (plus
buspirone) with data on TCAs and
benzodiazepines in this population. There are few randomised, placebo-controlled trials of medications for anxiety in children and adolescents, with most data coming from open-label trials and case series. Moreover, there are no studies comparing pharmacological versus behavioural treatments. Most recent data concerning the efficacy of
selective serotonin reuptake inhibitors suggests that these agents will be effective and safe in the treatment of paediatric
anxiety disorders. The potential side effect profiles of these newer agents also makes them an attractive first choice for anxiety when compared to the
benzodiazepines or TCAs, each of which poses its own potentially serious adverse effects. More research is needed in the area of psychopharmacological treatments for paediatric and adolescent anxiety, not only to substantiate the current beliefs that
serotonergic agents are effective and safe but to pinpoint the factors that might predict responses to particular agents or classes of medications. Future investigations should focus on treatments which have already proven effective for adult
anxiety disorders (both medications and psychotherapies), given the apparent links between paediatric and adult
anxiety disorders.