Comparative studies of pharmacotherapy for school refusal

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 29; no. 5; p. 773
• Main Authors: Bernstein, G A, Garfinkel, B D, Borchardt, C M
• Format: Journal Article
• Language: English
• Published: United States 01.09.1990
• Subjects: Adjustment Disorders - drug therapy; Adolescent; Alprazolam - therapeutic use; Anxiety Disorders - drug therapy; Child; Depressive Disorder - drug therapy; Double-Blind Method; Female; Humans; Imipramine - therapeutic use; Male; Phobic Disorders - drug therapy; Psychiatric Status Rating Scales
• ISSN: 0890-8567
• DOI: 10.1097/00004583-199009000-00016

Two studies compared alprazolam and imipramine in the treatment of school refusal. In an open label study (N = 17), two-thirds of the subjects completing a trial in both the alprazolam and imipramine groups showed moderate to marked global improvement in symptoms of anxiety and depression. In the double-blind, placebo-controlled study (N = 24), posttreatment scores calculated as change from baseline on the Anxiety Rating for Children were significantly different (p = .03) among the three treatment groups, with the active medication groups showing the most improvement. Additionally, on all depression rating scales, similar trends were evident with the alprazolam and imipramine groups demonstrating greater improvement than the placebo group. However, analyses of covariance (with pretreatment scores as the covariates) showed no significant differences among the three treatment groups on change in anxiety and depression scales. Thus, additional research is needed to determine whether trends in this study are explained by drug effect or baseline differences on rating scales.