Anxiety in Children: CBT and Sertraline Each Effective Alone, but More Effective Together

Cognitive behavorial therapy (CBT) and sertraline (Zoloft) each improve anxiety in children, but a combination of the two is even more effective, according to a study released online by the New England Journal of Medicine.

Nearly 500 children with separation anxiety disorder, generalized anxiety disorder, or social phobia were randomized to CBT (14 sessions), sertraline (starting dose, 25 mg/day, titrated up to 200 mg/day by 8 weeks), both, or a placebo pill. At 12 weeks, more children were rated as much improved or very much improved in the CBT group (60%), sertraline group (55%), and combination-therapy group (81%), compared with the placebo group (24%). Combination therapy proved more effective than either treatment alone.

There were no suicide attempts, and rates of suicidal or homicidal ideation were no higher with sertraline than with placebo.

The authors conclude that "all three of the [active] treatment options may be recommended, taking into consideration the family's treatment preferences, treatment availability, cost, and time burden."