SynthesisJournal of the American Academy of Child and Adolescent Psychiatry2018
The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis.
Synthesis in Journal of the American Academy of Child and Adolescent Psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04029740 (Searching for Exosomal microRNAs and Cellular Biomarkers and Mechanisms Underlying the Differences Between Panic Disorder Patients Who Are Responders and Non-responders to Cognitive Behavior Therapy), which is not on this map. Cited by 36 papers, 6 of them syntheses that pooled 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.
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.
Searching for Exosomal microRNAs and Cellular Biomarkers and Mechanisms Underlying the Differences Between Panic Disorder Patients Who Are Responders and Non-responders to Cognitive Behavior Therapy
Who cites it
36 citing papers in PubMed, 6 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Effectiveness of interventions for anxiety and depression in children and young people: an umbrella review of meta-analyses.European child & adolescent psychiatry · 2026Pooled it
- The Impact of Development on Antidepressant and Placebo Response in Anxiety Disorders: A Bayesian Hierarchical Meta-Analytic Examination of Randomized Controlled Trials in Children, Adolescents, and Adults.Journal of child and adolescent psychopharmacology · 2024Pooled it
- Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants.Clinical pharmacology and therapeutics · 2023Guideline
- The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder.Expert opinion on pharmacotherapy · 2023Pooled it
- Pharmacologic predictors of benzodiazepine response trajectory in anxiety disorders: a Bayesian hierarchical modeling meta-analysis.CNS spectrums · 2023Pooled it
- Antidepressant Tolerability in Pediatric Anxiety and Obsessive-Compulsive Disorders: A Bayesian Hierarchical Modeling Meta-analysis.Journal of the American Academy of Child and Adolescent Psychiatry · 2020Pooled it
- Predictors of response to pharmacotherapy in children and adolescents with psychiatric disorders: A combined post hoc analysis of four clinical trial data.Neuropsychopharmacology reports · 2022Trial
- Acute neurofunctional effects of escitalopram during emotional processing in pediatric anxiety: a double-blind, placebo-controlled trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Trial
- A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders.BMC psychiatry · 2021Trial
- Acceptability, Feasibility, and Utility of Integrating Pharmacogenetic Testing into a Child Psychiatry Clinic.Clinical and translational science · 2021Trial
- Escitalopram in Adolescents With Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study.The Journal of clinical psychiatry · 2020Trial
- CBT and pharmacotherapy after nonresponse for anxiety and obsessive-compulsive disorders in youth: a systematic review and meta-analysis.European child & adolescent psychiatry · 2026Review
- Effectiveness of selective serotonin reuptake inhibitors in inpatients with selective mutism compared to social anxiety disorder: an observational study.European child & adolescent psychiatry · 2026Observational
- Escitalopram and Sertraline Population Pharmacokinetic Analysis in Pediatric Patients.Clinical pharmacokinetics · 2023Article
- Anxiety in children and youth: Part 2-The management of anxiety disorders.Paediatrics & child health · 2023Review
- Review
- Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness.Children (Basel, Switzerland) · 2022Review
- A Double-Blind Randomized Trial to Investigate Mechanisms of Antidepressant-Related Dysfunctional Arousal in Depressed or Anxious Youth at Familial Risk for Bipolar Disorder.Journal of personalized medicine · 2022Article
- Pediatric Psychopharmacology for Depressive and Anxiety Disorders.Focus (American Psychiatric Publishing) · 2022Review
- Combining selective serotonin reuptake inhibitors and cognitive behavioral therapy in youth with depression and anxiety.Journal of affective disorders · 2022Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine the trajectory and magnitude of antidepressant response as well as the effect of antidepressant class and dose on symptomatic improvement in pediatric anxiety disorders.
methodWeekly symptom severity data were extracted from randomized, parallel group, placebo-controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) in pediatric anxiety disorders. Treatment response was modeled for the standardized change in continuous measures of anxiety using Bayesian updating. Posterior distributions for each study served as informative conjugate prior to distributions update subsequent study posteriors. Change in symptom severity was evaluated as a function of time, class and, for SSRIs, standardized dose.
resultsData from 9 trials (SSRIs: n = 5; SNRIs, n = 4) evaluating 7 medications in 1,673 youth were included. In the logarithmic model of treatment response, statistically, but not clinically, significant treatment effects emerged within 2 weeks of beginning treatment (standardized medication-placebo difference = -0.054, credible interval [CI] = -0.076 to -0.032, p = .005, approximate Cohen's d ≤ 0.2) and by week 6, clinically significant differences emerged (standardized medication-placebo difference = -0.120, CI = -0.142 to -0.097, p = .001, approximate Cohen's d = 0.44). Compared to SNRIs, SSRIs resulted in significantly greater improvement by the second week of treatment (p = .0268), and this advantage remained statistically significant through week 12 (all p values <.03). Improvement occurred earlier with high-dose SSRI treatment (week 2, p = .002) compared to low-dose treatment (week 10, p = .025), but SSRI dose did not have an impact on overall response trajectory (p > .18 for weeks 1-12).
conclusionsIn pediatric patients with generalized, separation, and/or social anxiety disorders, antidepressant-related improvement occurred early in the course of treatment, and SSRIs were associated with more rapid and greater improvement compared to SNRIs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.