Anxiety is a normal part of childhood, and every child goes through phases. The difference between a phase and an anxiety disorder is that a phase is temporary and usually harmless. While many children experience short-term phases of anxiety, those who suffer such that it causes them to avoid places and activities may be suffering from an anxiety disorder. Anxiety disorders in children can commonly co-exist with other issues, such as eating disorders or ADHD. Prescription medications together with behavioral therapy are successful in managing anxiety disorder symptoms.
SSRIs
Selective serotonin reuptake inhibitors (SSRIs) are considered the first line of treatment for childhood anxiety disorders, according to the Anxiety Disorders Association of America (ADAA). SSRIs target the chemical serotonin, which influences many of the behaviors in the brain. The most well-known and used SSRIs are fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa) and escitalopram (Lexapro). They are usually started at a low dose and gradually increased until a suitable dose is achieved. Many doctors prefer to prescribe SSRIs because they have fewer side effects than other medications used to treat anxiety disorders in children. The most common side effects, according to the the ADAA, are headache, stomachache or nausea, and difficulty sleeping.
Parents should be aware of a 2004 FDA warning stating that SSRIs may increase suicidal thoughts in a small number of children. Parents should be vigilant about behavior changes in of children who take SSRIs.
Tricyclic Antidepressants
Tricyclic antidepressants (TCAs) inhibit the reabsorption of serotonin and norepinephrine, two chemicals in the brain that serve as messengers to brain cells. TCAs, such as imipramine, have been around longer than SSRIs and, as such, have been studied longer in regard to their effectiveness in treating anxiety. That being said, the side effects of TCAs are more problematic, and many children report symptoms of dizziness, drowsiness, dry mouth and weight gain.
Benzodiazepines
Benzodiazepines, the most common class of anti-anxiety drugs, include medications such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam). These medications work to relieve anxiety by slowing down the central nervous system. These medications work quickly, bringing relief within an hour, making them a popular choice for treating anxiety-related panic attacks. Benzodiazepines have many side effects, which are even more pronounced when prescribed at higher doses. They include feeling sleepy, foggy and clumsy, which can cause difficulty functioning in everyday activities. These medications are metabolized slowly, which means they remain in the body for a long period of time and can result in over-sedation and developing a tolerance. Because of this, benzodiazepines are generally prescribed to children only for short periods of time.
