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 .
Maintenance treatment of adolescent bipolar disorder: open study of the effectiveness and tolerability of quetiapine
Background The purpose of the study was to determine the effectiveness and tolerability of quetiapine as a maintenance treatment preventing against relapse or recurrence of acute mood episodes in adolescent patients diagnosed with bipolar disorder . Methods Consenting patients meeting DSM-IV lifetime criteria for a bipolar disorder and clinical ly appropriate for maintenance treatment were enrolled in a 48-week open prospect i ve study . After being acutely stabilized ( CGI-S ≤ 3 for 4 consecutive weeks ) , patients were started or continued on quetiapine and other medications were weaned off over an 8-week period . Quetiapine monotherapy was continued for 40-weeks and other mood stabilizers or antidepressants were added if clinical ly indicated . A neurocognitive test battery assessing the most reliable findings in adult patients was administered at fixed time points throughout the study to patients and matched controls . Results Of the 21 enrolled patients , 18 completed the 48-week study . Thirteen patients were able to be maintained without relapse or recurrence in good quality remission  on quetiapine monotherapy , while 5 patients required additional medication to treat impairing residual depressive and /or anxiety symptoms . According to symptom ratings and global functioning scores , the quality of remission for all patients was very good . Neurocognitive test performance over treatment was equivalent to that of a matched control group of never ill adolescents . Quetiapine was generally well tolerated with no serious adverse effects . Conclusion This study suggests that a proportion of adolescent patients diagnosed with bipolar disorder can be successfully maintained on quetiapine monotherapy . The good quality of clinical remission and preserved neurocognitive functioning underscores the importance of early diagnosis and effective stabilization . Clinical Trials
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 .