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 extended-release carbamazepine monotherapy in children with bipolar disorder.
OBJECTIVE The aim of this study was to evaluate the safety and efficacy of extended release carbamazepine ( CBZ-ER ) monotherapy in the treatment of pediatric bipolar disorder ( BD ) . METHOD This was an 8-week , open-label , prospect i ve trial of CBZ-ER monotherapy ( 788 + /- 252 mg/day ) to assess the effectiveness and tolerability of this compound in treating pediatric bipolar spectrum disorders . Assessment s included the Young Mania Rating Scale ( YMRS ) , Clinical Global Impressions-Improvement scale , Children 's Depression Rating Scale , and Brief Psychiatric Rating Scale . Adverse events were assessed through spontaneous self-reports , vital signs weight monitoring , and laboratory analysis . RESULTS Of the 27 participating children with BD , 16 ( 59.% ) completed the study .  CBZ-ER treatment was associated with statistically significant , but modest , levels of improvement in mean YMRS scores ( -10.1 + /- 10.2 , p < 0.001 ) with end-point mean YMRS score ( 21.8 + /- 12.2 ) suggesting a lack of complete resolution of mania . CBZ-ER treatment also result ed in significant improvement in the severity of depressive , attention-deficit/hyperactivity disorder , and psychotic symptoms . With the exception of 2 participants who discontinued due to skin rash , CBZ-ER was well tolerated with marginal increase in body weight ( 0.8 + /- 2.5 kg , p = 0.04 ) and was not associated with any abnormal changes in laboratory parameters . CONCLUSIONS Open-label CBZ-ER treatment was beneficial for the treatment of BD in children . Future 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 .