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 .
An open-label study of aripiprazole in children with a bipolar disorder.
OBJECTIVE The purpose of this open-label study was to describe the effectiveness of aripiprazole ( APZ ) in the treatment of children with bipolar disorders suffering from manic symptomatology . METHOD Symptomatic out patients ( Young Mania Rating Scale [ YMRS ] score ≥15 ) meeting strict , unmodified , Diagnostic and Statistical Manual of Mental Disorders , 4th edition , diagnostic symptom criteria for a bipolar disorder , ages 4 - 9 years , were eligible . Subjects were treated prospect ively with flexible doses of APZ ( maximum daily dose of 15 mg/day ) , for up to 16 weeks or until a priori response criteria were met . Outcome measures included the YMRS , Clinical Global Impressions Scale-Severity , Children 's Global Assessment Scale ( CGAS ) , and the Children 's Depression Rating Scale-Revised ( CDRS-R ) . A priori response criteria consisted of 3 of 4 consecutive weeks with ( 1 ) CDRS-R < 29 ; ( 2 ) YMRS < 10 ; and ( 3 ) CGAS > 50 . RESULTS Ninety-six children ( 62 males ; mean age of 6.9 ( SD = 1.7 ) , received APZ for an average length of treatment of 12.5 ( SD = 3.9 ) weeks . Significant improvements in YMRS , CDRS-R , CGAS , and Clinical Global Impressions Scale-Severity scores ( p < 0.001 ) were noted at the end of study participation . Sixty of the subjects ( 62.5 % ) met a priori response criteria at study 's end . The most common side effects noted were stomachache , increased appetite , and headache . Two subjects were removed from the study due to side effects [ epistaxis ( n = 1 ) ; akathisia ( n = 1 ) ] . Subjects experienced an average weight gain of 2.4 ( SD = 1.9 ) kg . CONCLUSION APZ may be effective in the acute treatment of symptoms of children with bipolar illnesses
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 .