Fluoxetine, CBT, and Combination Beneficial for Youths With Anxiety Disorders

WEDNESDAY, July 8, 2026 (HealthDay News) — For youths with anxiety disorders, similar symptom reduction is seen with fluoxetine, cognitive behavioral therapy (CBT), and their combination, according to a study published online June 24 in The American Journal of Psychiatry.

Bradley S. Peterson, M.D., from Children”s Hospital Los Angeles, and colleagues conducted a 24-week sequential multiple assignment randomized trial in primary care and mental health clinics. Two 12-week treatment stages were employed among 316 youths (8 to 17 years of age) with severe anxiety and high levels of sociodemographic disadvantage and co-occurring diagnoses: random assignment to fluoxetine or CBT followed by random assignment to either continued initial treatment or combined treatment.

The researchers found a 31.7 percent decline in youth-reported Screen for Child Anxiety Related Emotional Disorders scores during the 24-week trial. There was no significant difference in improvement by initial treatment; CBT offered a nonsignificant advantage over medication (24-week difference in mean group change, 1.45; 95 percent confidence interval, −2.25 to 5.16). Combination treatment did not yield superior week 24 improvement over continuing monotherapy in week 12 nonremitters. On a subset of measures over 24 weeks, initial treatment with CBT followed by combination therapy significantly separated from other sequences.

“The good news is that in general, the treatments appear to be similarly effective in reducing anxiety so treatment choice can depend on family preference, accessibility, and other individual or contextual factors,” lead author Amy E. West, Ph.D., also from Children”s Hospital Los Angeles, said in a statement.

Two authors disclosed financial ties to the biopharmaceutical industry.

Abstract/Full Text