Small amounts of anxiety are normal in a child; however, when the levels of anxiety become distressing, treatment may be needed. Medication is an option for children, but parents should be cautious before giving pharmaceuticals to a child. The Anxiety Disorders Association of America's (ADAA) stance is "medications are used to treat anxiety disorders when symptoms cause significant subjective distress for the child and/or are contributing to persistent functional impairment such as difficulties at school, with peers or at home."
Selective Serotonin Reuptake Inhibitors
The most commonly prescribed medication for children with anxiety is selective serotonin reuptake inhibitors (SSRIs), according to the ADAA. SSRIs work by preventing serotonin, a neurotransmitter involved in mood, from being reabsorbed by the presynaptic cleft in the brain. By preventing reuptake, more serotonin is more available for use, thus improving the patient's mood. SSRIs that are given to children for anxiety include Lexapro (escitalopram), Celexa (citalopram), Luvox (fluvoxamine), Paxil (paroxetine), Zoloft (sertraline) and Prozac (fluoxetine).
Tricyclic Antidepressants
Tricyclic antidepressants are not given as often for anxiety in children, according to the ADAA. Tricyclic antidepressants have a similar mechanism compared to SSRIs, except the tricyclic antidepressants prevent the reuptake of both serotonin and norepinephrine, another neurotransmitter involved in mood regulation. An example of a tricyclic antidepressants used in anxiety treatment for children is imipramine.
Benzodiazepines
A third option for treating anxiety in a child is benzodiazepines, like lorazepam. However, benzodiazepines, even though they are specifically anti-anxiety medications, are not often given to children, according to the ADAA. The problem with benzodiazepines is that they can be very addictive: benzodiazepines act on the GABA receptor, which is the same receptor that ethanol acts on. Children who have a family history of alcoholism should not take benzodiazepines to treat anxiety.
Warning
In October 2004, the U.S. Food and Drug Administration (FDA) released a warning for children taking antidepressant medications, like SSRIs and tricyclic antidepressants. The FDA found that some children had an increase of suicidal thoughts and behaviors when taking antidepressants: 4 percent of antidepressant users, compared to 2 percent placebo users, had suicidal thoughts. Monitoring the child's behavior closely while she is on antidepressants is highly recommended.
