Child Anxiety: Therapy Plus Zoloft Best
Study Shows Cognitive Behavioral Therapy, Zoloft Work for Child Anxiety -- But Combo Is Best
WebMD News Archive
Dec. 24, 2008 - Cognitive behavioral therapy (CBT) and Zoloft are effective
treatments for childhood anxiety disorders -- but the combination works best, a
government-funded study shows.
Anxiety disorders and social phobias limit the lives of at least one in 10
children. Yet up to half of these kids aren't helped by short-term treatment
with psychotherapy alone or medications alone.
That's why Johns Hopkins researcher John T. Walkup, MD, and colleagues led a
multi-institution, government-funded study to see whether combination treatment
The researchers enrolled 488 children and teens age 7 to 17 years. All
separation anxiety disorder,
generalized anxiety disorder, or
There were four different treatment groups:
- 76 kids got inactive placebo pills.
- 133 kids got Zoloft alone -- beginning with 25 milligrams per day and
adjusted up to 200 milligrams per day within eight weeks, including eight 30-
to 60-minute sessions to rate treatment response and adverse events.
- 139 kids got CBT alone -- 14 one-hour sessions based on the Coping Cat
- 140 kids got combination treatment with CBT and Zoloft.
After 12 weeks:
- 24% of the kids in the placebo group were "very much" or
- 55% of the kids in the Zoloft group were "very much" or
- 60% of the kids in the CBT group were "very much" or "much"
- 81% of the kids in the CBT/Zoloft combination group were "very
much" or "much" improved.
Walkup and colleagues conclude that all three of the active treatments --
CBT, Zoloft, or the combination -- are effective short-term treatments for kids
with anxiety disorders.
"Among these effective therapies, combination therapy provides the best
chance for a positive outcome," they conclude.
Zoloft treatment worked the fastest, with rapid initial improvement but
little additional improvement after eight weeks of treatment. CBT took eight to
12 weeks to work.
Most kids with anxiety disorders don't get diagnosed or treated, notes an
editorial by Graham J. Emslie, MD, of the University of Texas Southwestern
Medical Center, Dallas.
That's too bad, he says, because research now shows that untreated childhood
anxiety persists into adulthood.