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 .
Efficacy and safety of quetiapine in children and adolescents with mania associated with bipolar I disorder: a 3-week, double-blind, placebo-controlled trial.
OBJECTIVE To evaluate the efficacy and safety of quetiapine monotherapy in children and adolescents with mania associated with bipolar I disorder . METHOD Patients aged 10 to 17 years , with a DSM-IV-TR diagnosis of a manic episode associated with bipolar I disorder and Young Mania Rating Scale ( YMRS ) total score ≥ 20 were r and omized to 3 weeks of quetiapine ( 400 or 600 mg/d ) or placebo . The primary efficacy measure was change in YMRS total score . The study was conducted at 34 centers in the United States between August 2004 and July 2006 . RESULTS The intent-to-treat population included 277 patients . Least squares mean change in YMRS score from baseline to end point by mixed-model , repeated- measures analysis was -14.25 , -15.60 , and -9.04 for quetiapine 400 mg/d , quetiapine 600 mg/d , and placebo , respectively ( P < .001 , each quetiapine dose vs placebo ) . Significant improvement in YMRS score versus placebo was first observed at day 4 ( P = .015 ) with quetiapine 400 mg/d and day 7 ( P < .001 ) with quetiapine 600 mg/d . Mean changes in body weight at day 21 ( observed cases ) were 1.7 kg for both quetiapine doses and 0.4 kg for placebo . Numerically larger mean increases in total cholesterol , low-density lipoprotein cholesterol , and triglycerides were observed with quetiapine than placebo . Adverse events associated with quetiapine were mostly mild to moderate in intensity . CONCLUSIONS In this 3-week study , quetiapine was significantly more effective than placebo in improving manic symptoms in youth with mania associated with bipolar disorder . Treatment was generally well tolerated and adverse events were broadly consistent with the known profile of quetiapine in adults with bipolar disorder . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00090311
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 .