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 .
Dopamine D2 receptor occupancy in vivo by the novel atypical antipsychotic olanzapine — a123 IBZM single photon emission tomography (SPET) study
We have studied striatal D2 dopamine binding in schizophrenic patients treated with the novel atypical antipsychotic drug , olanzapine.123I iodobenzamide ( IBZM ) single photon emission tomography ( SPET ) was used to estimate striatal dopamine D2 receptor binding in vivo . Patients were recruited from a prospect i ve , double blind controlled trial of olanzapine versus haloperidol treatment . In vivo striatal D2 binding data from olanzapine treated patients ( n=6 ) were compared with previously reported data from typical antipsychotic responsive ( n=10 ) ; clozapine ( n=10 ) ; and risperidone ( n=6 ) treated patient groups .  Mean % Brief Psychiatric Rating Scale score ( BPRS ) improvement following olanzapine treatment was 49 % ( SD 44 ) . The hypothesis that clinical improvement in olanzapine treated patients would be associated with higher mean striatal D2 binding of123I IBZM ( reflecting lower levels of D2 occupancy ) than typical antipsychotic ( 1.25±0.05 ) or risperidone ( 1.24±0.04 ) treatment was confirmed . Olanzapine treated patients had similar levels of striatal D2 binding in vivo ( 1.41±0.06 ) as those treated with clozapine ( 1.49±0.04 ) . This preliminary evidence suggests olanzapine is another atypical antipsychotic drug in which therapeutic response is not associated with a high degree of striatal D2 receptor occupancy in vivo
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 .