1. 1. Recommendation Report The Best Treatment Method for Teens with Anxiety Natalie Ortega 4/29/2015
2. 2. In the following sections of my presentation, I will provide further detail on my research methods, results, conclusion, and finally my recommendation.
3. 3. Introduction Many teens in the Unites States suffer with anxiety. In recent years, the number of teens struggling with anxiety has increased significantly. A national survey of mental health determined that about eight percent of teens ages 13-18 have an anxiety disorder (National Institute of Mental Health, 2014). More teens are looking for treatment. It is important to pick the right treatment for the right person, especially when prescribing treatments to people who have not yet reached adulthood. I conducted research that examined the cost, efficacy, and accessibility of three different methods of treatment. The methods of treatment I researched were Prozac, Lexapro, and Cognitive-behavioral therapy (CBT).
4. 4. Methods In order to obtain the information needed to asses each method of treatment, the project was organized into four tasks: 1. Find out the cost of each treatment 2. Gather information about each method of treatment from recent studies 3. Find comments and videos of patients who have used each method of treatment 4. Analyze data and submit my results
5. 5. Results Cost Based on my research, I was able to determine that the average cost of a month supply of 20 mg of Prozac is around $4-7. The average cost of Lexapro is around $11-14. I also found out that a session of CBT can cost anywhere from $120-210. However, these prices may vary due to the persons insurance provider and insurance plan Table 1. Average cost of each treatment method and percentage of cost covered by insurance Type of Treatment Cost per month/ session Prozac (20 mg) $4-10 Lexapro (20 mg) $11-14 Cognitive-Behavioral Therapy $120-210 Source: GoodRx, Psychology Today
6. 6. Results Efficacy according to Studies Studies of Prozac and CBT on teens had the best results of improving anxiety symptoms A study published in the Journal of Anxiety Disorders examined the effectiveness of cognitive-behavioral therapy (CBT) on children and teens. The study found that teens had significant improvements in their anxiety symptoms after receiving CBT (Kerns et al., 2013). One study of Prozac on teen anxiety found that 61% of participants taking Prozac showed improvement (Birmaher et al., 2003).
7. 7. Results Efficacy According to Studies Figure 1. Source: Journal of Anxiety Disorders, Volume 27, Issue 2
8. 8. Results Reports from Teens that have used each Method of Treatment The majority of videos and comments I found of teens sharing their experiences with CBT had positive experiences with this therapy. The videos teens made about Lexapro and Prozac did not include as many reports of improvement as cognitive-behavioral therapy. One teen said: I have had enormous success using CBT to keep my anxiety in check, enough that I enjoy parts of life that I never could before (Anna B, 2012). Most of the videos I found of teens who have taken Lexapro had a mediocre or negative experiences with the medication. One teen said she would not recommend Lexapro to anyone (RGsDevilship, 2012).
9. 9. Conclusion Cost Compared to CBT and Lexapro, Prozac would be the least expensive treatment method. The average cost of Prozac is around $4-7 for a monthly supply, while the cost of Lexapro is around $11-14 and a session of CBT is about $120-210. Although the average cost of Prozac is cheaper, the price may vary depending on the pharmacy and the insurance provider of the person who will be purchasing the medication. Efficacy according to Studies CBT and Prozac were both effective treatment methods for teens according to studies Reports from Teens According to teens who reported their experiences with each method of treatment, teens saw the most improvement in their anxiety with CBT.
10. 10. Recommendation Based on my research, I was unable to generalize a treatment method that would be the most effective, cost efficient, and accessible for teens with anxiety. I was unable to makes this recommendation for three main reasons: The total cost of the medication can differ depending on the amount of time a person will have to take the medication or attend therapy. The cost can also change depending on the persons insurance provider and insurance plan. Some teens may need a combination of talk-therapy and medication to effectively treat their anxiety The type of treatment that would be best suited for teens with anxiety can differ based on the severity of the teens anxiety and the teens medical history.
11. 11. References Anxiety Disorders in Children and Adolescents (Fact Sheet). (2014, January 1). Retrieved March 4, 2015, from http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/index.shtml The National Institute of Mental Health website offers information about different mental disorders and treatment methods. I looked into the information the site provided about anxiety disorders and the clinical trials of different treatments on teens with anxiety. The section about anxiety disorders also includes a link to a pdf of a fact sheet that includes statistics and results of surveys of people with anxiety. I used this website to find statistics of teens with anxiety in the Unites States and included this information in my introduction. The source could also be useful to people who want to identify symptoms of anxiety. B, Anna. (2012, Dec 19). When anxiety interrupts a childs life [Web log comment] Retrieved from http://well.blogs.nytimes.com/2012/12/17/helping-children-gain-control-over-an-anxiety-disorder/?_r=0 Birmaher, B., Axelson, D. A., Monk, K., Kalas, C., Clark, D. B., Ehmann, M.,& Brent, D. A. (2003). Fluoxetine for the treatment of childhood anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 42(4), 415-423. This article documents a study published in the Journal of the American Academy of Child & Adolescent Psychiatry. The researchers of the study tested the efficacy of fluoxetine (Prozac) on children and teens with anxiety. The participants were randomly assigned to either take fluoxetine or a placebo. The effects of the medication were recorded after 12 weeks by an intent-to-treat analysis. I used this article in the results section of my report. I used the data from this study to provide an efficacy measure of Prozac on treating teens with anxiety. Consumer Reports: Generic drug prices vary by store (2013).CBS Interactive. Retrieved March 28, 2015, from http://www.cbsnews.com/news/consumer-reports-generic-drug-prices-vary-by-store/ This article covers a news story that investigates the cost of prescription drugs. The source explains that more and more people around the United States are avoiding refilling their prescriptions because of the high cost. The article lists the cost of several popular medications and explains that prices can vary significantly based on the pharmacy where the medication is purchased. I used this source in the results section of my report to discuss the cost of each method of treatment.
12. 12. David, D., Lupu, V., Sava, F. A., Szentagotai, A., & Yates, B. T. (2009). Cost-effectiveness and cost-utility of cognitive therapy, rational emotive behavioral therapy, and fluoxetine (Prozac) in treating depression: a randomized clinical trial. Journal of Clinical Psychology, 65, 36. In this article, researchers compared the cost-effectiveness and cost-utility of talk-therapy and Prozac. The study performed a randomized clinical trial of each treatment for 14 weeks on a sample of 170 clients. The study used the Beck Depression Inventory (BDI) to obtain anxiety scores of clients before and after treatment. These scores were then compared to the cost of each method of treatment. I used the results of this study in the results section of my report. I used it provide information about the cost of talk-therapy and Prozac. Escitalopram (Lexapro). (2015). Retrieved March 28, 2015, from http://www.goodrx.com/escitalopram/price Fluoxetine (Prozac) (2015). Retrieved March 28, 2015, from http://www.goodrx.com/prozac/price Kerns, C. M., Read, K. L., Klugman, J., & Kendall, P. C. (2013). Cognitive behavioral therapy for youth with social anxiety: Differential short and long-term treatment outcomes. Journal Of Anxiety Disorders, 27(2), 210-215. doi:10.1016/j.janxdis.2013.01.009 Lusk, P., & Melnyk, B. M. (2013). COPE for depressed and anxious teens: A brief cognitivebehavioral skills building intervention to increase access to timely, evidencebased treatment. Journal of Child and Adolescent Psychiatric Nursing, 26, 31. doi:10.1111/jcap.12017 COPE (Creating Opportunities for Personal Empowerment) is a treatment program for depressed and anxious teens that divides therapy into 30 minute outpatient sessions. The article discusses the goals of this program and the lessons that would be taught in each session. The article also discusses how this type of therapy program would be particularly beneficial to teens. I used this article to emphasis the growing population of teens with anxiety in my introduction. I used information from this article that stated how many teens are dealing with a mental disorder nationwide. Psychology Today Therapists (2002). Retrieved from https://therapists.psychologytoday.com/rms/prof_detail.php?profid=74241&sid=1429079470.4133_25942&city=Houston&count y=Harris&state=TX&spec=293&tr=ResultsName RGsDevilship. (2012, Dec 16). Life after Lexapro [Video file]. Retrieved from https://www.youtube.com/watch?v=HIX9ccjeF30