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 .
A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania.
OBJECTIVE To determine the comparative efficacy of quetiapine and divalproex for the treatment of adolescent mania . METHOD Fifty adolescents ( ages 12 - 18 years ) with bipolar I disorder , manic or mixed episode , were r and omized to quetiapine ( 400 - 600 mg/day ) or divalproex ( serum level 80 - 120 microg/mL ) for 28 days for this double-blind study , which was conducted from July 2002 through January 2004 . The primary efficacy measure was change in Young Mania Rating Scale ( YMRS ) score across the study period . RESULTS Repeated measures analysis of variance using the last-observation carried forward data indicated no statistically significant group difference in YMRS scores across the 28 days of the study ( p = 0.3 ) . Mixed regression analyses ( comparison of slopes ) revealed that improvement in YMRS scores occurred more rapidly in the quetiapine than in the divalproex group for both the last-observation carried forward ( p = 0.01 ) and observed data ( p = 0.03 ) . Response and remission rates were significantly greater in the quetiapine than in the divalproex group ( p < .03 ) . Rates of adverse events did not differ significantly between groups . CONCLUSIONS The results suggest that quetiapine is at least as effective as divalproex in the treatment of acute manic symptoms associated with adolescent bipolar disorder ; however , a quicker reduction of manic symptoms may occur with quetiapine as compared with divalproex . Quetiapine may be useful as monotherapy for the treatment of adolescents with manic or mixed episodes , although placebo-controlled studies are necessary
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 .