Pharmacologic Treatments for Pediatric Bipolar Disorder: A Review and Meta-Analysis

Liu, Howard Y.; Potter, Mona P.; Woodworth, K. Yvonne; Yorks, Dayna; Petty, Carter R.; Wozniak, Janet; Faraone, Stephen V.; Biederman, Joseph

doi:10.1016/j.jaac.2011.05.011

Cited by 112 publications

(74 citation statements)

References 69 publications

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“…69 In 2011, a systematic review of randomized controlled trials published from 1989 to 2010 on the pharmacotherapy of pediatric mania was published. 70 The authors found 29 open-label and 17 randomized clinical trials of antimanic agents conducted with 2,666 children and adolescents with BD. The main conclusions were that the best results were found in the double-blind studies of aripiprazole, olanzapine, quetiapine, and risperidone.…”

Section: University Of Pittsburgh Medicalmentioning

confidence: 99%

Mood disorders in childhood and adolescence

Rocha

Zeni

Caetano

et al. 2013

Rev. Bras. Psiquiatr.

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The identification and treatment of mood disorders in children and adolescents has grown over the last decades. Major depression is one of the most common and debilitating disorders worldwide, imposing a massive burden to the youth population. Bipolar disorder is being increasingly recognized as having its roots early in life, and its presentation during childhood and adolescence has been submitted to extensive research. This review aims to highlight clinical aspects of the current knowledge on mood disorders in the pediatric population, presenting updated information on epidemiology, diagnostic procedures, and management strategies. Limitations of available evidence and future directions of research in the field are also discussed.

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Section: University Of Pittsburgh Medicalmentioning

confidence: 99%

Mood disorders in childhood and adolescence

Rocha

Zeni

Caetano

et al. 2013

Rev. Bras. Psiquiatr.

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“…Early recognition of the symptoms of bipolar disorder and prompt initiation of effective treatment are key to reducing the disease burden in these youth, with the potential for associated improvements in both short-and long-term outcomes (Perlis et al 2009). Although there is growing evidence to characterize the efficacy and safety of interventions in pediatric bipolar mania and/or mixed states, there are to date no large, multisite, placebo-controlled studies published for any pharmacologic intervention in pediatric bipolar depression (Kowatch et al 2005;Liu et al 2011).…”

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confidence: 99%

Efficacy and Safety of Extended-Release Quetiapine Fumarate in Youth with Bipolar Depression: An 8 Week, Double-Blind, Placebo-Controlled Trial

Findling

Pathak

Earley³

et al. 2014

Journal of Child and Adolescent Psychopharmacology

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Objective: Quetiapine is an atypical antipsychotic with demonstrated efficacy in the treatment of adolescent schizophrenia and pediatric bipolar mania. Large, placebo-controlled studies of interventions in pediatric bipolar depression are lacking. The current study investigated the efficacy and safety of quetiapine extended-release (XR) in patients 10-17 years of age, with acute bipolar depression. Methods: This multicenter, double-blind, randomized, placebo-controlled study investigated quetiapine XR (dose range, 150-300 mg/day) in pediatric outpatients with an American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) diagnosis of bipolar I or bipolar II disorder (current or most recent episode depressed) treated for up to 8 weeks (ClinicalTrials.gov identifier: NCT00811473). The primary study outcome was mean change in Children's Depression Rating Scale-Revised (CDRS-R) total score. Secondary efficacy outcomes included CDRS-R-based response and remission rates. Results: Of 193 patients randomized to treatment, 144 patients completed the study (75.3% of quetiapine XR group [n = 70]; 74.0% of placebo group [n = 74]). Least squares mean changes in CDRS-R total score at week 8 were: -29.6 (SE, 1.65) with quetiapine XR and -27.3 (SE, 1.60) with placebo, a between-treatment group difference of -2.29 (SE, 1.99; 95% CI, -6.22, 1.65; p = 0.25; mixed-model for repeated measures analysis). Rates of response and remission did not differ significantly between treatment groups. The safety profile of quetiapine XR was broadly consistent with the profile reported previously in adult studies of quetiapine XR and pediatric studies of quetiapine immediate-release (IR). Potentially clinically significant elevations in clinical chemistry values included triglycerides (9.3%, quetiapine XR; 1.4%, placebo group) and thyroid stimulating hormone (4.7%, quetiapine XR; 0%, placebo group). An adverse event potentially related to diabetes mellitus occurred in 3.3% of the quetiapine XR versus no adverse events in the placebo group. Conclusions: Quetiapine XR did not demonstrate efficacy relative to placebo in this 8 week study of pediatric bipolar depression. Quetiapine XR was generally safe and well tolerated.

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“…A meta-analysis of pharmacotherapy trials in pediatric patients with bipolar disorder showed overall modest effects of the various treatments (traditional mood stabilizers, other anticonvulsants, second-generation antipsychotics, and naturopathic compounds), although there was a lack of studies in children younger than 10 years. [51]. The few studies available including preschool-aged children are mostly open trials and will be reviewed below.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%