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 trial of risperidone in children and adolescents with bipolar disorder.
OBJECTIVE The aim of this study was to evaluate the potential of risperidone as a treatment of  pediatric bipolar disorder .  METHODS This was an 8-week , open-label , prospect i ve study of risperidone monotherapy ( 1.25 + /- 1.5 mg/d ) for 30 bipolar youths ( manic , mixed , or hypomanic ; 6 - 17 years of age ) . RESULTS Twenty-two of the 30 youths ( 73 % ) completed the study . Using predefined criteria for improvement ( a Clinical Global Impressions Improvement in Mania score of < or = 2 at endpoint ) , the response rate for manic symptoms was 70 % . The significant reduction in symptoms of mania result ed in a mean Young Mania Rating Scale ( YMRS ) score 13.5 at endpoint , indicating mild residual symptoms . Weight increased significantly from baseline ( 2.1 + /- 2.0 kg ; p < 0.001 ) and there was a four-fold increase in prolactin levels from baseline ( p < 0.001 ) . CONCLUSIONS Open-label risperidone treatment was associated with a significant shortterm improvement of symptoms of pediatric bipolar disorder . Future placebo-controlled , double-blind studies are needed to confirm these preliminary results
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 .