Table 2. Pharmacologic treatment for children with generalized anxiety disorder.
*First-line treatment
SSRI: selective serotonin reuptake inhibitor; bid: twice a day; SNRI: serotonin-norepinephrine reuptake inhibitor
| Medication | Drug class | Formulation | Dosing | Minimum duration | Potential side effects | Special notes |
| Fluoxetine* | SSRI | Capsule, tablet, or liquid | Starting dose: 10 mg/day; typical dose: 20-60 mg/day | 4-8 weeks | Treatment-induced suicidality, increased BMI, and mania | Contraindicated with the use of tricyclic antidepressants, antiarrhythmic drugs, and neuroleptics. A longer half-life causes this drug to have the smallest occurrence of withdrawal symptoms |
| Sertraline* | SSRI | Capsule, tablet, or liquid | Starting dose: 25 mg/day; maximum dose: 200 mg/day | 4-8 weeks | Headache, nausea, vomiting, abdominal pain, diarrhea, dyspepsia, and insomnia | Bid dosing is recommended in adolescents due to its short half-life. Decreased absorption with food. Well tolerated in children ages 6-17 |
| Duloxetine | SNRI | Capsule or tablet | Starting dose: 30 mg/day; maximum dose: 120 mg/day | 6-8 weeks | Weight loss, constipation, dry mouth, drowsiness, and increased heart rate | FDA approved |