Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2021
Acute Neurofunctional Effects of Escitalopram in Pediatric Anxiety: A Double-Blind, Placebo-Controlled Trial.
Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02818751 (Neurofunctional Predictors of Escitalopram Treatment Response in Adolescents With Anxiety), which is not on this map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
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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.
Neurofunctional Predictors of Escitalopram Treatment Response in Adolescents With Anxiety
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Altered amygdala resting-state functional connectivity in anxiety disorders: a coordinate-based meta-analysis.Psychological medicine · 2026Pooled it
- The medial prefrontal cortex as a proposed regulatory structure in the relationship between anxiety and perceived social support: a review.BMC psychology · 2025Pooled it
- Deprescribing Antidepressants in Children and Adolescents: A Systematic Review of Discontinuation Approaches, Cross-Titration, and Withdrawal Symptoms.Journal of child and adolescent psychopharmacology · 2025Pooled 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
- Effects of light therapy on amygdala connectivity and serotoninergic system in young adults with subthreshold depression.Dialogues in clinical neuroscience · 2025Trial
- Neurostructural Differences in Adolescents With Treatment-Resistant Depression and Treatment Effects of Transcranial Magnetic Stimulation.The international journal of neuropsychopharmacology · 2022Trial
- Executive Functioning in Pediatric Anxiety and Its Relationship to Selective Serotonin Reuptake Inhibitor Treatment Response: A Double-Blind, Placebo-Controlled Trial.Journal of child and adolescent psychopharmacology · 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
- Nociceptin/orphanin FQ receptor agonism attenuates behavioral and neural responses to conditioned aversive stimuli.Translational psychiatry · 2026Article
- Distinct Trajectories of Amygdala Connectivity Patterns Characterize Remission vs. Non-Remission in Patients With Major Depressive Disorder.Depression and anxiety · 2026Article
- Neuroimaging as a Tool for Advancing Pediatric Psychopharmacology.Paediatric drugs · 2025Review
- Article
- Heterogeneous Brain Atrophy Sites in Anxiety Disorders Map to a Common Brain Network.Depression and anxiety · 2024Article
- 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
- Neurocircuitry of treatment in anxiety disorders.Biomarkers in neuropsychiatry · 2022Article
- Tools to Address Children's Mental Health.Focus (American Psychiatric Publishing) · 2022Article
- Target to treatment: A charge to develop biomarkers of response and tolerability in child and adolescent psychiatry.Clinical and translational science · 2022Review
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveAmygdala-ventrolateral prefrontal cortex (VLPFC) circuitry is disrupted in pediatric anxiety disorders, yet how selective serotonin reuptake inhibitors (SSRIs) affect this circuitry is unknown. We examined the impact of the SSRI escitalopram on functional connectivity (FC) within this circuit, and whether early FC changes predicted treatment response in adolescents with generalized anxiety disorder (GAD).
methodResting-state functional magnetic resonance (MR) images were acquired before and after 2 weeks of treatment in 41 adolescents with GAD (12-17 years of age) who received double-blind escitalopram or placebo for 8 weeks. Change in amygdala-based whole-brain FC and anxiety severity were analyzed.
resultsControlling for age, sex, and pretreatment anxiety, escitalopram increased amygdala-VLPFC connectivity compared to placebo (F = 17.79, p = .002 FWE-corrected). This early FC change predicted 76.7% of the variability in improvement trajectory in patients who received escitalopram (p < .001) but not placebo (p = .169); the predictive power of early amygdala-VLPFC FC change significantly differed between placebo and escitalopram (p = .013). Furthermore, this FC change predicted improvement better than baseline FC or clinical/demographic characteristics. Exploratory analyses of amygdala subfields' FC revealed connectivity of left basolateral amygdala (BLA) -VLPFC (F = 19.64, p < .001 FWE-corrected) and superficial amygdala-posterior cingulate cortex (F = 22.92, p = .001 FWE-corrected) were also increased by escitalopram, but only BLA-VLPFC FC predicted improvement in anxiety over 8 weeks of treatment.
conclusionIn adolescents with GAD, escitalopram increased amygdala-prefrontal connectivity within the first 2 weeks of treatment, and the magnitude of this change predicted subsequent clinical improvement. Early normalization of amygdala-VLPFC circuitry might represent a useful tool for identifying future treatment responders as well as a promising biomarker for drug development. CLINICAL TRIAL REGISTRATION INFORMATION: Neurofunctional Predictors of Escitalopram Treatment Response in Adolescents With Anxiety; https://www.clinicaltrials.gov/; NCT02818751.
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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.