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 lamotrigine adjunct or monotherapy for the treatment of adolescents with bipolar depression.
OBJECTIVE The treatment of pediatric bipolar depression has not been well studied . The authors wished to prospect ively study the efficacy of lamotrigine as adjunctive or monotherapy in adolescents with bipolar disorder who were experiencing a depressive episode . METHOD This was an 8-week open-label trial of lamotrigine with 20 adolescents ages 12 - 17 years ( mean age 15.8 ; 7 boys , 13 girls ) with diagnoses of bipolar disorder I , II , or not otherwise specified , who were experiencing a depressive episode .  Lamotrigine was begun at 12.5 to 25 mg/day . Primary response criteria was a 1 or a 2 on the Clinical Global Impression-Improvement at week 8 . A secondary criterion was at least a 50 % decrease in Children 's Depression Rating Scale-Revised scores . RESULTS Nineteen subjects completed the trial . The mean final dose was 131.6 mg/day . Seven subjects were taking other psychotropic medications . Sixteen subjects ( 84 % ) responded by primary criteria , and 12 ( 63 % ) responded to our secondary criteria . Eleven subjects ( 58 % ) were considered in remission at week 8 . Young Mania Rating Scale and Overt Aggression Scale-Modified scores also decreased significantly during the trial . There was no significant weight change , rash , or other adverse effects during the trial . CONCLUSIONS Adolescents with bipolar depression appeared to respond to lamotrigine treatment , whether as adjunctive therapy or monotherapy , with decreases in depression , mania , and aggression . Larger , placebo-controlled studies of lamotrigine are needed in this population
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 .