The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog ran from 2006 to 2016 and was intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    CBT + sertraline reduces anxiety in children

     Both cognitive behavioral therapy (CBT) and sertraline (Zoloft) reduce anxiety in children with anxiety disorders.

    Combined, they achieve better response rates.

    First, the details.

    • 488 children with separation anxiety disorder, generalized anxiety disorder, or social phobia were randomly assigned to treatment.
      • 14 sessions of CBT
      • Sertraline (up to 200 mg per day) for 12 weeks
      • Sertraline + CBT for 12 weeks
      • Placebo for 12 weeks
    • Anxiety severity and impairment were assessed at the start of treatment and at weeks 4, 8, and 12.
    • The Clinician Global Impression–Improvement scale (CGI) was used to measure improvement.

    And, the results.

    • A significant percentage of children were “very much” or “much” improved based on CGI.
      • 81% with combination therapy
      • 60% for CBT
      • 55% for sertraline
    • All therapies were significantly better than placebo (24%).
    • On the Pediatric Anxiety Rating Scale, combination therapy was better than CBT, which was equivalent to sertraline.
      • All therapies were superior to placebo.
    • Adverse events, including suicidal and homicidal ideation, were no more frequent with sertraline than placebo.
      • No child attempted suicide.
    • There was less insomnia, fatigue, sedation, and restlessness associated with CBT vs sertraline.

    The bottom line?
    The National Institutes of Mental Health recommends that if you’re interested in getting psychological treatment for general anxiety disorder, ask if the therapist offers CBT and/or behavioral therapy and is open to using medication if needed.

    12/27/08 18:10 JR

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