Children’s social fears may be ameliorated with medication

The question: Day-to-day situations – conversing with friends, playing sports, giving a class presentation –- make some children and teens extremely anxious. Paxil (paraoxetine) can help adults with this condition, called social anxiety disorder. Does it also help young people?

This study randomly assigned 322 youths with the disorder to take Paxil or a placebo daily for 16 weeks. Participants ranged in age from 8 to 17. Overall, 78 percent of those who took the drug showed improvement, most within the first four weeks, compared with 38 percent of the placebo group. By the end of the study, the disorder was deemed in remission for 35 percent of the Paxil group vs. 8 percent of the others.

Who may be affected by these findings? Young people with social anxiety disorder. More than 5 million Americans have this disorder, which usually begins in childhood or adolescence.

Caveats: Use of antidepressants by people under 18 has raised concerns about an increased risk of suicide. In this study, four young people taking Paxil reported such thoughts, but no case was considered serious and the incidents were not attributed to the study medication. Youths who took Paxil reported more side effects, especially insomnia, decreased appetite and vomiting. The effect of long-term use of the drug remains unclear. The study was funded by GlaxoSmithKline, which makes Paxil; six of the nine authors worked for the drug company and the other three have received fees from it.

Bottom line: Parents of a child with social anxiety disorder may want to talk with a doctor about Paxil.

Find this study in the November issue of Archives of General Psychiatry; abstract available online at www.archgenpsychiatry.com.

Learn more about social anxiety disorder at www.nimh.nih.gov and www.adaa.org.