RESULTS There is sufficient evidence for a Grade A recommendation of the use of olanzapine plus fluoxetine at reducing depressive symptoms in bipolar depression and of quetiapine at high doses for depressive symptoms occurring during mixed episodes .
These results mostly overlap with the approved treatments for bipolar depression in adults
BACKGROUND The management of depressive and mixed symptoms in children and adolescents with bipolar disorder ( BD ) remains a matter of debate .
The goal of this review is , thus , to systematic ally examine the impact of atypical antipsychotics ( AAPs ) and mood stabilisers in the treatment of bipolar depression and /or mixed states .
A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania.
OBJECTIVES This r and omized , double-blind , placebo-controlled study examined the efficacy and tolerability of quetiapine in combination with divalproex ( DVP ) for acute mania in adolescents with bipolar disorder . It was hypothesized that DVP in combination with quetiapine would be more effective than DVP alone for treating mania associated with adolescent bipolar disorder . Furthermore , it was hypothesized that quetiapine would be well tolerated . METHOD Thirty manic or mixed bipolar I adolescents ( 12 - 18 years ) received an initial DVP dose of 20 mg/kg and were r and omly assigned to 6 weeks of combination therapy with quetiapine , which was titrated to 450 mg/day ( n = 15 ) or placebo ( n = 15 ) . Primary efficacy measures were change from baseline to endpoint in Young Mania Rating Scale ( YMRS ) score and YMRS response rate . Safety and tolerability were assessed weekly . RESULTS The DVP + quetiapine group demonstrated a statistically significantly greater reduction in YMRS scores from baseline to endpoint than the DVP + placebo group ( F(1,27 ) = 5.04 , p = .03 ) . Moreover , YMRS response rate was significantly greater in the DVP + quetiapine group than in the DVP + placebo group ( 87 % versus 53 % ; Fisher exact test , p = .05 ) . No significant group differences from baseline to endpoint in safety measures were noted . Sedation , rated as mild or moderate , was significantly more common in the DVP + quetiapine group than in the DVP + placebo group . CONCLUSIONS The findings of this study indicate that quetiapine in combination with DVP is more effective for the treatment of adolescent bipolar mania than DVP alone . In addition , the results suggest that quetiapine is well tolerated when used in combination with DVP for the treatment of mania
RESULTS There is sufficient evidence for a Grade A recommendation of the use of olanzapine plus fluoxetine at reducing depressive symptoms in bipolar depression and of quetiapine at high doses for depressive symptoms occurring during mixed episodes .
These results mostly overlap with the approved treatments for bipolar depression in adults
BACKGROUND The management of depressive and mixed symptoms in children and adolescents with bipolar disorder ( BD ) remains a matter of debate .
The goal of this review is , thus , to systematic ally examine the impact of atypical antipsychotics ( AAPs ) and mood stabilisers in the treatment of bipolar depression and /or mixed states .