2.9 A Multicenter Double-Blind, Placebo-Controlled Trial of Escitalopram in Children and Adolescents With Generalized Anxiety Disorder

Machine Learning‐Based Prediction of Escitalopram and Sertraline Side Effects With Pharmacokinetic Data in Children and Adolescents

“…Escitalopram and sertraline‐related side effects were consistent with previous clinical studies 3,4,7 . The finding that activation‐cluster side effects are associated with differences in sertraline clearance aligns with previous reports in fluoxetine, fluvoxamine, and escitalopram 2,28,33 ; however, we did not observe a difference in escitalopram clearance, which has been previously reported 2 .…”

“…After accounting for age, we were unable to detect a relationship at a 5% significance threshold. Although sertraline is indicated for obsessive‐compulsive disorder in patients as young as 6 years old, 8 escitalopram was until recently only approved in patients older than 11 years 3,7 ; this is reflected in this study as patients treated with sertraline were as young as 5 years old and the youngest escitalopram‐treated patient was 10 years old. Given the differences in indicated populations between SSRIs, future studies could investigate the relationship of age with variation in tolerability and pharmacokinetics, especially as clearance and age may be correlated.…”

“…Psychiatric disorders are prevalent and associated with significant morbidity and mortality in children and adolescents 1 . Importantly, selective serotonin reuptake inhibitors (SSRIs), including escitalopram and sertraline, are effective in treating anxiety disorders, 2–4 depression, 5–7 and other mental health disorders 8 in youth; however, many experience side effects 9–11 . Current antidepressant dosing strategies in youth frequently follow a “one size fits all” approach, where an initial standard dose is selected and then slowly titrated until the patient responds or experiences side effects.…”

The effectiveness of using escitalopram in pediatric generalized anxiety disorder and the methods to predict the treatment response: A systematic review and meta-analysis

“…Fifty records were excluded; among these 50, three trials matched our eligibility criteria, but their results were not posted. [13][14][15] The reasons for exclusion are provided in Figure 1. Finally, five studies were included in this paper.…”

“…Additionally, it is worth mentioning that these changes described in the amygdala during emotional processing may show some contrast in anxious adults since a study reported that the magnitude of treatment response by venlafaxine was predicted by lower amygdala activity at the baseline. 35 The final method was the use of executive functions (EFs) as a predictor of treatment response, which is defined as a set of general-purpose control processes that are responsible for regulating behaviors and thoughts. It is linked to the prefrontal cortex, which is responsible for managing the dynamics of cognition and actions.…”