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 .
Olanzapine versus placebo in the treatment of adolescents with bipolar mania.
OBJECTIVE The purpose of this study was to evaluate the efficacy and safety of olanzapine for the treatment of acute manic or mixed episodes associated with bipolar disorder in adolescents . METHOD A 3-week multicenter , parallel , double-blind , r and omized placebo-controlled trial was conducted at 24 sites in the United States and two sites in Puerto Rico . The participants were outpatient and inpatient male and female adolescents 13 - 17 years of age with an acute manic or mixed episode . Subjects received either olanzapine  ( 2.5 - 20 mg/day [ N=107 ] ) or placebo ( N=54 ) . The mean change from baseline to endpoint in the Young Mania Rating Scale total score was the primary outcome measure . RESULTS The mean baseline-to-endpoint change in the Young Mania Rating Scale total score was significantly greater for patients receiving olanzapine relative to patients receiving placebo , and a greater proportion of olanzapine-treated patients met response and remission criteria ( 44.8 % versus 18.5 % and 35.2 % versus 11.1 % , respectively ) . The mean baseline-to-endpoint weight change was significantly greater for patients receiving olanzapine relative to patients receiving placebo ( 3.7 kg versus 0.3 kg ) , and the incidence of treatment-emergent weight gain > or = 7 % of baseline was higher for olanzapine-treated patients ( 41.9 % versus 1.9 % ) . The mean baseline-to-endpoint changes in prolactin , fasting glucose , fasting total cholesterol , uric acid , and the hepatic enzymes aspartate transaminase and alanine transaminase were significantly greater in patients treated with olanzapine relative to patients receiving placebo . CONCLUSIONS Olanzapine was effective in the treatment of bipolar mania in adolescent patients . Patients treated with olanzapine , however , had significantly greater weight gain and increases in the levels of hepatic enzymes , prolactin , fasting glucose , fasting total cholesterol , and uric acid
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 .