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 .
Lithium treatment of acute mania in adolescents: a placebo-controlled discontinuation study.
OBJECTIVE There are no published placebo-controlled studies of any agent in the treatment of acute mania in children or adolescents . This is the first placebo-controlled study of lithium 's efficacy in the treatment of acute mania in adolescents . METHOD In this discontinuation study , participants received open treatment with lithium at therapeutic serum levels ( mean 0.99 mEq/L ) for at least 4 weeks . Responders were r and omly assigned to continue or discontinue lithium during a 2-week double-blind , placebo-controlled phase . This study had 80 % power to detect a 40 % difference in exacerbation rates between groups ( 10 % on lithium versus 50 % on placebo ) . RESULTS Twenty-three of 40 protocol participants ( 57.5 % ) experienced a clinical ly significant symptom exacerbation during the 2-week double-blind phase . However , the slightly lower exacerbation rate in the group maintained on lithium ( 10/19 or 52.6 % ) versus the group switched to placebo ( 13/21 or 61.9 % ) did not reach statistical significance . CONCLUSIONS This study does not support a large effect for lithium continuation treatment of adolescents with acute mania , mostly due to the unexpectedly high rate of exacerbations in the group that continued on lithium . Further studies are warranted to clarify whether acute mania in adolescents is lithium responsive
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 .