Objective: Despite lack of evidence, various pharmacological agents are judiciously used to manage anxiety in
avoidant restrictive food intake disorder (
ARFID). We aimed to explore the effectiveness of
selective serotonin reuptake inhibitors (
SSRIs), either alone or in combination with
hydroxyzine, in a well-defined cohort of children and adolescents with
ARFID receiving treatment in a
partial hospitalization program for
eating disorders. Methods: We conducted a retrospective chart review of 53 patients with
ARFID who were prescribed an SSRI (n = 39) or SSRI with
hydroxyzine (n = 14). We investigated changes from admission to discharge in these two medication groups on various outcome measures assessing weight, eating behaviors, mood, anxiety, and fears about food. Results: Participants in the SSRI+hydroxyzine group were significantly older than those in the SSRI only group. The majority of participants in both groups exhibited the fear presentation of
ARFID. Repeated-measures analysis of variance yielded a significant main effect for treatment for all outcome measures, indicating that patients in both groups experienced improvements in weight, eating behaviors, mood, anxiety, and fears of food. A significant main effect for medication group emerged on the Children's Depression Inventory, suggesting that the group receiving SSRI+hydroxyzine experienced greater depressive symptomatology than the SSRI-only group. We did not find any significant interactions, indicating that participants in both medication groups experienced similar improvements over the course of treatment. Conclusion: These results provide preliminary evidence that
SSRIs and
hydroxyzine may be helpful in the treatment of children and adolescents with
ARFID. Given that
hydroxyzine was prescribed to patients who experienced high pre- and/or postmeal anxiety, it possibly contributed to similar decreases in anxiety and fear of food in a more challenging subset of patients. Randomized, placebo-controlled studies for children and adolescents with
ARFID are warranted to better evaluate and understand the efficacy of
SSRIs and
hydroxyzine in this clinical population.