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 trial of quetiapine monotherapy in preschool and school age children with bipolar spectrum disorder.
BACKGROUND Although bipolar disorder frequently onsets in the preschool years , treatment studies to guide management of these highly dysfunctional children are limited . This study evaluates the response to quetiapine monotherapy in preschool and school age children with bipolar spectrum disorder ( BSD ) . METHOD Two eight-week , prospect i ve , open-label trials utilizing identical methodology to assess the effectiveness and tolerability of quetiapine monotherapy in the treatment of BSD in preschool ( age 4 - 6 years ) and school age children ( age 6 - 15 years ) . RESULTS Forty-nine children ( 30 preschool and 19 school age ) with BSD ( Young Mania Rating Scale [ YMRS ] at entry : 34.5±5.5 and 30±6.5 respectively ) were enrolled and 34 ( 20 preschool and 14 school age ) completed the trial . Quetiapine was titrated to a mean endpoint dose of 175.8±63.8 mg/day in preschool and 248.7±153.1 mg/day in school age children . At endpoint , treatment with quetiapine was associated with similar and statistically significant improvement in mean YMRS scores in preschool ( -14.5±11.5 , p<0.001 ) and school age ( -13±9.8 , p<0.001 ) children . Quetiapine was generally well tolerated with treatment limiting adverse-events observed in 3/30 preschool and 1/19 school age children . Quetiapine monotherapy in preschool and school age children was associated with significant weight gain ( + 3.1±1.8 and + 7.4±7.7 lb respectively , p<0.001 ) and with clinical ly insignificant changes in vital signs . LIMITATIONS As an uncontrolled study , the assessment s were not blind to treatment and the effects of treatment can not be separated from time . CONCLUSIONS Open-label quetiapine treatment was beneficial for the treatment of BSD in preschool and school age children . Further controlled trials 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 .