Original Title: Traitement pharmacologique – Trouble anxieux ou trouble obsessionnel-compulsif chez les jeunes de 12 à 17 ans

Authors' objectives: To improve access to mental health care, the Ministère de la Santé et des Services sociaux launched, in 2017, the Québec Program for Mental Disorders: From Self-Care to Psychotherapy. As part of this program, and in collaboration with the Ministère, the Institut national d’excellence en santé et en services sociaux developed, as an initial component, a clinical tool on anxiety symptoms and disorders in young people aged 12 to 17. The present work constitutes the second component of the project and aims to support health professionals in initiating, when deemed appropriate, pharmacological treatment for young people aged 12 to 17 who have an anxiety disorder (agoraphobia, separation anxiety disorder, generalized anxiety disorder, social anxiety disorder/social phobia, specific phobia, or panic disorder) or an obsessive-compulsive disorder, as well as in ensuring follow-up of such treatment, if applicable.

Authors' results and conclusions: RESULTS (#1 PRIORITIZING NON-PHARMACOLOGICAL INTERVENTIONS): Non-pharmacological interventions (psychosocial interventions or psychotherapies) are the first treatment options for anxiety disorder and obsessive-compulsive disorder in young people. However, certain situations may warrant the use of pharmacological treatment. (#2 CONSIDERING PHARMACOLOGICAL TREATMENT IN CERTAIN SITUATIONS): The decision to initiate pharmacological treatment or not should take into account, among other factors, the severity of symptoms, level of functioning, comorbidities, medical history, whether non-pharmacological interventions have been tried and their effectiveness, the acceptability or feasibility of non-pharmacological interventions, the risk of suicide and the values and preferences of the youth, their family, or their close network. (#3 READING THE AVAILABLE SCIENTIFIC DATA): Regarding the most common adverse effects of selective serotonin reuptake inhibitors (e.g., headache, nausea, drowsiness, insomnia, abdominal pain), they generally occur during the first few weeks of treatment, and most of them subside or disappear shortly thereafter. (#4 CHOOSING TREATMENT BASED ON THE YOUNG PERSON’S CLINICAL SITUATION AND MEDICATION CHARACTERISTICS): The use of a serotonin-norepinephrine reuptake inhibitor (duloxetine or extended-release venlafaxine) may be considered by the child and adolescent psychiatry team in certain situations. CONCLUSION: Without replacing clinical judgment, this tool should help optimize practices related to the initiation of pharmacological treatment, when deemed appropriate, for young people who have an anxiety disorder or an obsessive-compulsive disorder by providing clear and nuanced guidance to facilitate therapeutic decisions.

Authors' methods: First, a systematic review of primary studies and a systematic review of documents containing information and clinical recommendations on anxiety disorder or obsessivecompulsive disorder were conducted to document clinical aspects. The systematic review of primary studies sought to evaluate the efficacy and safety of selective serotonin reuptake inhibitors in young people aged 12 to 17 with one of these disorders. The systematic review of documents containing information or clinical recommendations aimed to document best practices for initiating and monitoring use of these drugs. Narrative literature reviews were conducted to document the population-level, sociocultural, organizational, economic and environmental dimensions.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/symptomes-et-troubles-anxieux-chez-les-jeunes-de-12-a-17-ans.html

Year Published: 2026

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/ServicesSociaux/Traitement_pharmaco_TA_TOC_GN_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)