Evidence map›Paper›PMID 25449861›Full record

SynthesisDepression and anxiety2015

Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis.

Jeffrey R Strawn, Jeffrey A Welge, Anna M Wehry, Brooks Keeshin, Moira A Rynn

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Depression and anxiety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 10 pooled it
18.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 10 syntheses or guidelines pooled it, 183 citations in OpenAlex.

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  11. Acute Neurofunctional Effects of Escitalopram in Pediatric Anxiety: A Double-Blind, Placebo-Controlled Trial.Journal of the American Academy of Child and Adolescent Psychiatry · 2021
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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Jeffrey R StrawnDepartment of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, Ohio; Department of Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Jeffrey A Welge
Anna M Wehry
Brooks Keeshin
Moira A Rynn
University of Cincinnati Medical Center · USColumbia University · US

Funding

Cincinnati Center for Clinical and Translational Sciences and TrainingUL1TR000077 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., TSEVAT, JOEL · 2012 to 2014
$9.9M
Neurofunctional Predictors of Treatment Response in Adolescents with GADK23MH106037 · NIMH · UNIVERSITY OF CINCINNATI · PI STRAWN, JEFFREY ROBERT · 2014 to 2017
$745k
NCATS NIH HHS 8 UL1 TR000077-04NCATS NIH HHS UL1 TR000077NIMH NIH HHS K23 MH106037NIMH NIH HHS K23MH106037
6 · The paper itself

Abstract

backgroundRandomized controlled trials have demonstrated that antidepressants are efficacious in the treatment of anxiety disorders in youth. However, there are no recent, systematic analyses of the efficacy, safety, or tolerability of these medications in pediatric anxiety disorders.

methodsA systematic review and meta-analysis of prospective, randomized, parallel-group, controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric patients with non-obsessive compulsive disorder (OCD) anxiety disorders was undertaken using a search of PubMed/Medline (1966-2014). The meta-analysis utilized random-effects models to evaluate change in the Pediatric Anxiety Rating Scale or similar anxiety scale, suicidality, and adverse events. Additionally, pharmacologic variables were explored with regard to effect size, although no correction for multiple comparisons was made with regard to these relationships.

resultsNine trials involving 1,673 patients and six medications were included. All SSRI/SSNRIs evaluated demonstrated efficacy, and the meta-analytic estimate of effect was of moderate magnitude (Cohen's d = 0.62, confidence interval [CI]: 0.34-0.89, P = .009) and there was evidence of modest heterogeneity (I(2) = 0.29, P = .103). Activation trended toward being more likely with antidepressant treatment (OR: 1.86, CI: 0.98-3.53, P = .054), but no increased risk was observed for nausea/abdominal symptoms (P = .262), discontinuation as a result of an adverse event (P = .132), or suicidality (OR: 1.3, CI: 0.53-3.2, P = .514). Finally, the effect size correlated with the serotonergic specificity of the agent (R = .79, P = .021).

conclusionsData for nine SSRI/SSNRIs suggest superiority of antidepressants relative to placebo for the treatment of pediatric anxiety disorders with a moderate effect size.

Indexed as

AdolescentAntidepressive AgentsAnxietyAnxiety DisordersChildHumansProspective StudiesPsychiatric Status Rating ScalesRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsSerotonin and Noradrenaline Reuptake InhibitorsSuicidal IdeationAntidepressive AgentsSelective Serotonin Reuptake InhibitorsSerotonin and Noradrenaline Reuptake Inhibitorsantidepressantsanxietyanxiety disorderschild/adolescentGADgeneralized anxiety disorderpharmacotherapyseparation anxiety

Identifiers

PMID25449861
PMCPMC4514767
OpenAlexW2125405058

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.