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 .
Combination lithium and divalproex sodium in pediatric bipolarity.
OBJECTIVE Lithium carbonate ( Li ) or divalproex sodium ( DVPX ) may be effective for some juveniles with bipolar disorder . Many youths with bipolar disorder do not respond to DVPX or Li monotherapy . An open-label study was conducted to examine the effectiveness of combination DVPX and Li therapy with youths diagnosed with bipolar disorder . METHOD Patients meeting DSM-IV criteria for bipolar I or bipolar II disorder , ages 5 to 17 years , were treated prospect ively for up to 20 weeks with DVPX + Li . Assessment s included the Young Mania Rating Scale ( YMRS ) , Children 's Depression Rating Scale-Revised ( CDRS-R ) , and the Children 's Global Assessment Scale ( CGAS ) . The a priori definition of clinical remission utilized included four contiguous weekly ratings of YMRS < /=12.5 , CDRS-R < /=40 , CGAS > /=51 , clinical stability , and no evidence of mood cycling . RESULTS Ninety patients ( 66 males , 24 females ) were treated . Significant improvement ( p < .0001 ) in all outcome measures was observed by week 8 as well as at the end of study . The mean time in study was 11.3 weeks . Forty-seven percent ( n = 42 ) met a priori criteria for remission . CONCLUSIONS Symptoms of mania and depression in juvenile bipolar disorder may be safely and effectively treated acutely with DVPX + Li
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 .