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 .
Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study.
OBJECTIVES To evaluate the efficacy , safety , and tolerability of risperidone monotherapy for the treatment of an acute mixed or manic episode in children and adolescents with bipolar I disorder . METHODS This r and omized , placebo-controlled , double-blind , 3-arm study ( N = 169 ) included children and adolescents ( ages 10 - 17 years ) with a DSM-IV diagnosis of bipolar I disorder , experiencing a manic or mixed episode . Study participants were r and omized to placebo ( n = 58 ) , risperidone 0.5 - 2.5 mg/day ( n = 50 ) , or risperidone 3 - 6 mg/day ( n = 61 ) for 3 weeks . The primary efficacy measure was change in Young Mania Rating Scale ( YMRS ) total score from baseline to end point . Safety assessment s included adverse event ( AE ) monitoring and scores on extrapyramidal symptom rating scales . RESULTS Improvement in mean YMRS total score was significantly greater in risperidone-treated subjects than in placebo-treated subjects [ mean change ( SD ) -9.1 ( 11.0 ) for placebo ; -18.5 ( 9.7 ) for risperidone 0.5 - 2.5 mg ( p < 0.001 ) ; -16.5 ( 10.3 ) for risperidone 3 - 6 mg ( p < 0.001 ) ] . The most common risperidone-associated  AEs were somnolence , headache , and fatigue . Mean ( SD ) weight gain was 0.7 ( 1.9 ) kg , 1.9 ( 1.7 ) kg , and 1.4 ( 2.4 ) kg in the placebo , risperidone 0.5 - 2.5 mg , and risperidone 3 - 6 mg groups , respectively , during this 3-week study . CONCLUSIONS At daily doses of 0.5 - 2.5 mg and 3 - 6 mg , risperidone was effective and well tolerated in children and adolescents experiencing acute manic or mixed episodes of bipolar I disorder . Results indicate that risperidone 0.5 - 2.5 mg has a better benefit-risk profile than risperidone 3 - 6 mg
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 .