Medicating Childhood Anxiety: What the FDA's Approval of Escitalopram for Kids Really Tells Us About Risk, Evidence, and Trust

In 2023 the FDA approved escitalopram, sold as Lexapro, for generalized anxiety disorder in children as young as seven, a decision resting largely on a single industry-sponsored trial that showed only a modest statistical advantage over placebo on the Pediatric Anxiety Rating Scale. What that approval did not make headlines for was the roughly sixfold increase in treatment-emergent suicidal ideation observed in the trial data, a finding that puts the entire risk-benefit calculus into sharp relief for clinicians and families alike. This episode breaks down the trial methodology, what the evidence actually supports, how industry funding shapes the research landscape in pediatric psychopharmacology, and what psychologists and parents need to understand before accepting a prescription as a first-line answer to a child's anxiety.