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 prospective open-label treatment trial of ziprasidone monotherapy in children and adolescents with bipolar disorder.
OBJECTIVE To assess the effectiveness and tolerability of ziprasidone for treating pediatric mania . METHODS This was an eight-week , open-label , prospect i ve study of ziprasidone monotherapy ( 57.3 + /- 33.9 mg/day ) in 21 bipolar youth [ manic , mixed , or bipolar not otherwise specified ( NOS ) ; 6 - 17 years old ] . Assessment s included the Young Mania Rating Scale ( YMRS ) , Clinical Global Impressions-Improvement scale ( CGI-I ) , and Brief Psychiatric Rating Scale ( BPRS ) . Adverse events were assessed through spontaneous self-reports , vital signs , weight monitoring , and laboratory analysis . RESULTS Fourteen of the 21 youth ( 67 % ) completed the study .  Ziprasidone treatment was associated with clinical ly and statistically significant improvement in mean YMRS scores ( -10.8 + /- 8.4 , p < 0.0001 ) and 57 % had a CGI-I < or=2 at endpoint . Ziprasidone was well tolerated with no statistically significant increase in body weight ( 0.6 + /- 0.4 kg , p = 0.2 ) or QTc interval ( -3.7 + /- 4.7 , p = 0.5 ) . CONCLUSIONS Open-label ziprasidone treatment was associated with a significant short-term improvement of symptoms of pediatric bipolar disorder . Future placebo-controlled , double-blind studies are warranted
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 .