Fluoxetine for the Treatment of Childhood and Adolescence Social Phobia: Factors playing a role in Efficacy

Abstract

Fluoxetine for the treatment of childhood and adolescence social phobia: factors playing a role in efficacy Objective: The aim of this study was to investigate the stepwise efficacy, after 8 and 12 weeks of fluoxetine treatment, on social anxiety disorder (SAD) in 7 to 17 year-old children and adolescents (n=40) and to explore the variables that determine the response to treatment. Method: The study had a naturalistic design where the results were analyzed retrospectively. The baseline measures included the Clinical Global Impression-Severity, the Self-Report for Childhood Anxiety Related Disorders, the Social Anxiety Scale for Children-Revised (SASC-R), and the maternal Liebowitz Social Anxiety Scale. At 8 and 12 weeks, patients were rated on the Clinical Global Impression-Improvement, while children and adolescents completed the Self-Report for Childhood Anxiety Related Disorders. Results: Fluoxetine was significantly effective for SAD and well tolerated. The beneficial effect increased over time. A multiple regression model was constructed to determine the best linear combination of age, presence of a comorbid anxiety disorder, baseline SASC-R scores, duration of SAD, maternal social anxiety scores, and family history for depression and anxiety disorders. This combination of variables significantly predicted the SASC-R scores at 12 weeks (F(6,99)=91.5, p=0.01). Conclusion: The results of this study reveal that fluoxetine is effective and well tolerated for the acute treatment of social anxiety disorder in children and adolescents. The results suggest that younger age, lower baseline social anxiety scores, absence of a family history for depression and/or anxiety disorders, and lower maternal social anxiety scores predict a better outcome. Although overlapping anxiety symptoms of comorbid disorders may persist, the improvement of SAD is more likely when the children or adolescents have a comorbid anxiety disorder.