The majority of adolescents with substance abuse disorders have comorbid psychiatric diagnoses, especially anxiety.83, 84 Substance use increases risk for traumatic events and often interferes with appropriate detection and treatment of anxiety disorders.85 Anxiety disorders also pose greater risk for developing eating disorders, including anorexia nervosa,86 and binge eating.87 Patients may vigilantly Inhibitors,research,lifescience,medical attend to food limits to address their anxiety around eating and its consequences, while nutritional benefits often impair brain function and judgment. Fear of eating may further result in extreme avoidance

to psychotherapy. There is minimal evidence supporting Inhibitors,research,lifescience,medical the use of SSRIs to aid weight restoration,88 yet pharmacologic management may nevertheless be helpful to address co-occurring anxiety or depression. Children with Autism Spectrum Disorders (ASDs) often exhibit agitation and anxious responses to many stimuli, including ritualistic and obsessive behaviors.89 The most common comorbid diagnosis with ASDs is social anxiety

disorder.90 One meta-analysis of the limited data on treatment of children with ASDs found that SSRI treatment was associated with reduced anxiety, decreased repetitive behaviors, and improved global function.91 Inhibitors,research,lifescience,medical Androgen Receptor antagonist However, two recent autism studies using citalopram and fluoxetine for ritualistic behaviors were negative, and another meta-analysis raised concerns for lack Inhibitors,research,lifescience,medical of efficacy and risk of side effects when compared with placebo groups.92, 93 Clinical recommendations nevertheless include consideration of SSRI use with symptoms of anxiety in some children

and adolescents with autism spectrum disorder.94 Although Inhibitors,research,lifescience,medical trichotillomania, or impulsive repetitive hairpulling, is listed as an impulse control disorder, the triggers for repetitive hair-pulling are often anxious thoughts,95 and urges to pull are typically accompanied by anxiety.95, 96 However, treatment studies using SSRIs have shown low response rates.97, 98 CBT with “habit reversal therapy” is the recommended first-line treatment.99 While co-occurrence of the motor impairments of Tourette’s Disorder with OCD is very common, treatment of one disorder is not Phosphatidylinositol diacylglycerol-lyase thought to significantly impact the symptomatic impairments related to the other.100 In contrast to pharmacotherapy for anxiety disorders in youth, there are many more FDA approved-medications for the treatment of anxiety in adults. These include multiple benzodiazepindes (alprazolam, clomipramine, clorazepate, lorazepam, oxazepam); multiple SSRIs (paroxetine, fluoxetine, fluvoxamine, escitalopram, sertraline); SNRIs (venlafaxine); tricyclics (amitriptyline), MAO inhibitors (phenelzine), and miscellaneous agents (buspirone and hydroxyzine). These findings do not necessarily support use in youth.