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Treatment of childhood-onset bipolar disorder

  • Robert L. Findling
Part of the Milestones in Drug Therapy book series (MDT)

Abstract

Because pediatric bipolar disorder is a serious condition, there is a substantive need for evidence- based treatments for children and adolescents suffering from this condition. A fundamental intervention used in this patient population is pharmacotherapy. Despite the importance of medication treatment in this patient population, only limited amounts of methodologically stringent data exist pertaining to this form of intervention. The evidence that does exist suggests that some psychotropic medications can provide salutary effects for youths suffering from Bipolar I disorder. Also relevant is the pharmacotherapy of genetically at-risk children suffering from bipolar spectrum disorder, and treatment of psychiatric co-morbidities. Further placebo-controlled trials are needed in order to better characterize the efficacy and safety of psychotropic medication in this population.

Keywords

Bipolar Disorder Bipolar Depression Acad Child Adolesc Psychiatry Divalproex Sodium Bipolar Mania 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Birmaher B, Axelson D (2006) Course and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature. Dev Psychopathol 18: 1023–1035PubMedCrossRefGoogle Scholar
  2. 2.
    McClellan J, Kowatch R, Findling RL (2007) Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 46: 107–125PubMedCrossRefGoogle Scholar
  3. 3.
    Pavuluri MN, Birmaher B, Naylor MW (2005) Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 44: 846–871PubMedCrossRefGoogle Scholar
  4. 4.
    Kowatch RA, Fristad M, Birmaher B, Wagner KD, Findling RL, Hellander M (2005) Treatment guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 44: 213–235PubMedCrossRefGoogle Scholar
  5. 5.
    Wiznitzer M, Findling RL (2003) Why do psychiatric drug research in children? Lancet 361: 1147–1148PubMedCrossRefGoogle Scholar
  6. 6.
    Kraepelin E (1921) Manic-depressive insanity and paranoia. E&S Livingstone, EdinburghGoogle Scholar
  7. 7.
    Findling RL, McNamara NK, Gracious BL, Youngstrom EA, Stansbrey RJ, Reed MD, Demeter CA, Branicky LA, Fisher KE, Calabrese JR (2003) Combination lithium and divalproex sodium in pediatric bipolarity. J Am Acad Child Adolesc Psychiatry 42: 895–901PubMedCrossRefGoogle Scholar
  8. 8.
    Alessi N, Naylor MW, Ghaziuddin M, Zubieta JK (1994) Update on lithium carbonate therapy in children and adolescents. J Am Acad Child Adolesc Psychiatry 33: 291–304PubMedCrossRefGoogle Scholar
  9. 9.
    Kafantaris V, Coletti DJ, Dicker R, Padula G, Kane JM (2003) Lithium treatment of acute mania in adolescents: a large open trial. J Am Acad Child Adolesc Psychiatry 42: 1038–1045PubMedCrossRefGoogle Scholar
  10. 10.
    Kowatch RA, Suppes T, Carmody TJ, Bucci JP, Hume JH, Kromelis M, Emslie GJ, Weinberg WA, Rush AJ (2000) Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 39: 713–720PubMedCrossRefGoogle Scholar
  11. 11.
    DelBello MP, Kowatch RA, Adler CM, Stanford KE, Welge JA, Barzman DH, Nelson E, Strakowski SM (2006) A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania. J Am Acad Child Adolesc Psychiatry 45: 305–313PubMedGoogle Scholar
  12. 12.
    Wagner KD, Weller EB, Carlson GA, Sachs G, Biederman J, Frazier JA, Wozniak P, Tracy K, Weller RA, Bowden C (2002) An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 41: 1224–1230PubMedCrossRefGoogle Scholar
  13. 13.
    Pavuluri MN, Henry DB, Carbray JA, Naylor MW, Janicak PG (2005) Divalproex sodium for pediatric mixed mania: a 6-month prospective trial. Bipolar Disord 7: 266–273PubMedCrossRefGoogle Scholar
  14. 14.
    Wagner KD, Redden L, Kowatch RA, Wilens T, Segal S, Chang K, Wozniak P, Vigna NV, Schmitz PJ, Abi-Saab W et al (2007) Safety and efficacy of divalproex ER in youth with mania. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  15. 15.
    Kowatch RA, Findling RL, Scheffer RE, Stanford K (2007) Pediatric Bipolar Collaborative Mood Stabilizer Trial. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  16. 16.
    DelBello MP, Findling RL, Kushner S, Wang D, Olson WH, Capece JA, Fazzio L, Rosenthal NR (2005) A pilot controlled trial of topiramate for mania in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 44: 539–547PubMedCrossRefGoogle Scholar
  17. 17.
    Wagner KD, Kowatch RA, Emslie GJ, Findling RL, Wilens TE, McCague K, D’Souza J, Wamil A, Lehman RB, Berv D et al (2006) A double-blind, randomized, placebo-controlled trial of oxcarbazepine in the treatment of bipolar disorder in children and adolescents. Am J Psychiatry 163: 1179–1186PubMedCrossRefGoogle Scholar
  18. 18.
    Wozniak J, Biederman J, Mick E,Waxmonsky J, Hantsoo L, Best C, Cluette-Brown JE, Laposata M (2007) Omega-3 fatty acid monotherapy for pediatric bipolar disorder: a prospective open-label trial. Eur Neuropsychopharmacol 17: 440–447PubMedCrossRefGoogle Scholar
  19. 19.
    Pandina G, DelBello MP, Kushner S, VanHove I, Augustyns I, Kusumaker V, Haas M (2007) Risperidone for the treatment of acute mania in bipolar youth. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  20. 20.
    Tohen M, Kryzhanovskaya L, Carlson G, DelBello M,Wozniak J, Kowatch R,Wagner K, Findling R, Lin D, Robertson-Plouch C et al (2007) Olanzapine versus placebo in the treatment of adolescents with bipolar mania. Am J Psychiatry 164: 1547–1556PubMedCrossRefGoogle Scholar
  21. 21.
    DelBello MP, Findling RL, Earley WR, Acevedo LD, Stankowski J (2007) Efficacy of quetiapine in children and adolescents with bipolar mania: a 3-week, double-blind, randomized, placebo-controlled trial. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  22. 22.
    Chang KD, Nyilas M, Aurang C, Johnson B, Jin N, Marcus R, Forbes RA, Carson WH, Kahn A, Findling RL (2007) Efficacy of aripiprazole in children (10-17 years old) with mania. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  23. 23.
    DelBello MP, Versavel M, Ice K, Keller D, Miceli J (2006) Ziprasidone dosing study in pediatric patients with bipolar disorder, schizophrenia, or schizoaffective disorder. Presented at: Association of European Psychiatrists’ 14th European Congress of Psychiatry: 4–8 March 2006, Nice, FranceGoogle Scholar
  24. 24.
    Biederman J, Mick E, Hammerness P, Harpold T, Aleardi M, Dougherty M, Wozniak J (2005) Open-label, 8-week trial of olanzapine and risperidone for the treatment of bipolar disorder in preschool-age children. Biol Psychiatry 58: 589–594PubMedCrossRefGoogle Scholar
  25. 25.
    Biederman J, Mick E,Wozniak J, Aleardi M, Spencer T, Faraone SV (2005) An open-label trial of risperidone in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol 15: 311–317PubMedCrossRefGoogle Scholar
  26. 26.
    Frazier JA, Biederman J, Tohen M, Feldman PD, Jacobs TG, Toma V, Rater MA, Tarazi RA, Kim GS, Garfield SB et al (2001) A prospective open-label treatment trial of olanzapine monotherapy in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol 11: 239–250PubMedCrossRefGoogle Scholar
  27. 27.
    Marchand WR, Wirth L, Simon C (2004) Quetiapine adjunctive and monotherapy for pediatric bipolar disorder: a retrospective chart review. J Child Adolesc Psychopharmacol 14: 405–411PubMedCrossRefGoogle Scholar
  28. 28.
    Barnett MS (2004) Ziprasidone monotherapy in pediatric bipolar disorder. J Child Adolesc Psychopharmacol 14: 471–477PubMedCrossRefGoogle Scholar
  29. 29.
    Barzman DH, DelBello MP, Kowatch RA, Gernert B, Fleck DE, Pathak S, Rappaport K, Delgado SV, Campbell P, Strakowski SM (2004) The effectiveness and tolerability of aripiprazole for pediatric bipolar disorders: a retrospective chart review. J Child Adolesc Psychopharmacol 14: 593–600PubMedCrossRefGoogle Scholar
  30. 30.
    Biederman J, McDonnell MA, Wozniak J, Spencer T, Aleardi M, Falzone R, Mick E (2005) Aripiprazole in the treatment of pediatric bipolar disorder: a systematic chart review. CNS Spectr 10: 141–148PubMedGoogle Scholar
  31. 31.
    Kowatch RA, Suppes T, Gilfillan SK, Fuentes RM, Grannemann BD, Emslie GJ (1995) Clozapine treatment of children and adolescents with bipolar disorder and schizophrenia: a clinical case series. J Child Adolesc Psychopharmacol 5: 241–253CrossRefGoogle Scholar
  32. 32.
    Masi G, Mucci M, Millepiedi S (2002) Clozapine in adolescent inpatients with acute mania. J Child Adolesc Psychopharmacol 12: 93–99PubMedCrossRefGoogle Scholar
  33. 33.
    DelBello MP, Schwiers ML, Rosenberg HL, Strakowski SM (2002) A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry 41: 1216–1223PubMedCrossRefGoogle Scholar
  34. 34.
    Kowatch RA, Sethuraman G, Hume JH, Kromelis M, Weinberg WA (2003) Combination pharmacotherapy in children and adolescents with bipolar disorder. Biol Psychiatry 53: 978–984PubMedCrossRefGoogle Scholar
  35. 35.
    Findling RL, McNamara NK, Stansbrey R, Gracious BL, Whipkey RE, Demeter CA, Reed MD, Youngstrom EA, Calabrese JR (2006) Combination lithium and divalproex sodium in pediatric bipolar symptom re-stabilization. J Am Acad Child Adolesc Psychiatry 45: 142–148PubMedCrossRefGoogle Scholar
  36. 36.
    Pavuluri MN, Henry DB, Carbray JA, Sampson G, Naylor MW, Janicak PG (2004) Open-label prospective trial of risperidone in combination with lithium or divalproex sodium in pediatric mania. J Affect Disord 82Suppl 1: S103–111PubMedCrossRefGoogle Scholar
  37. 37.
    Patel NC, DelBello MP, Bryan HS, Adler CM, Kowatch RA, Stanford K, Strakowski SM (2006) Open-label lithium for the treatment of adolescents with bipolar depression. J Am Acad Child Adolesc Psychiatry 45: 289–297PubMedCrossRefGoogle Scholar
  38. 38.
    Chang K, Saxena K, Howe M (2006) An open-label study of lamotrigine adjunct or monotherapy for the treatment of adolescents with bipolar depression. J Am Acad Child Adolesc Psychiatry 45: 298–304PubMedCrossRefGoogle Scholar
  39. 39.
    Young RC, Biggs JT, Ziegler VE, Meyer DA (1978) A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 133: 429–435PubMedCrossRefGoogle Scholar
  40. 40.
    Kowatch RA, DelBello MP, Findling RL (2002) Depressive episodes in children and adolescents with bipolar disorders. Clinical Neurosciences Research 2: 158–160CrossRefGoogle Scholar
  41. 41.
    Kafantaris V, Coletti DJ, Dicker R, Padula G, Pleak RR, Alvir JM (2004) Lithium treatment of acute mania in adolescents: a placebo-controlled discontinuation study. J Am Acad Child Adolesc Psychiatry 43: 984–993PubMedCrossRefGoogle Scholar
  42. 42.
    Findling RL, McNamara NK, Youngstrom EA, Stansbrey R, Gracious BL, Reed MD, Calabrese JR (2005) Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry 44: 409–417PubMedCrossRefGoogle Scholar
  43. 43.
    Wagner KD, Nyilas M, Johnson B, Aurang C, Forbes A, Marcus R, Carson WH, Iwamoto T, Carlson GA (2007) Long-term efficacy of aripiprazole in children (10-17 years) with mania. Presented at: 54th Annual Meeting of the American Academy of Child and Adolescent Psychiatry: 23–28 October 2007, Boston, MAGoogle Scholar
  44. 44.
    Findling RL, Youngstrom EA, McNamara NK, Stansbrey RJ, Demeter CA, Bedoya D, Kahana SY, Calabrese JR (2005) Early symptoms of mania and the role of parental risk. Bipolar Disord 7: 623–634PubMedCrossRefGoogle Scholar
  45. 45.
    Geller B, Cooper TB, Zimerman B, Frazier J,Williams M, Heath J,Warner K (1998) Lithium for prepubertal depressed children with family history predictors of future bipolarity: a double-blind, placebo-controlled study. J Affect Disord 51: 165–175PubMedCrossRefGoogle Scholar
  46. 46.
    Chang KD, Dienes K, Blasey C, Adleman N, Ketter T, Steiner H (2003) Divalproex monotherapy in the treatment of bipolar offspring with mood and behavioral disorders and at least mild affective symptoms. J Clin Psychiatry 64: 936–942PubMedGoogle Scholar
  47. 47.
    Findling RL, Frazier TW, Youngstrom EA, McNamara NK, Stansbrey RJ, Gracious BL, Reed MD, Demeter CA, Calabrese JR (2007) Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment of symptomatic youth at high risk for developing bipolar disorder. J Clin Psychiatry 68: 781–788PubMedCrossRefGoogle Scholar
  48. 48.
    DelBello MP, Adler CM, Whitsel RM, Stanford KE, Strakowski SM (2007) A 12-week singleblind trial of quetiapine for the treatment of mood symptoms in adolescents at high risk for developing bipolar I disorder. J Clin Psychiatry 68: 789–795PubMedCrossRefGoogle Scholar
  49. 49.
    Scheffer RE, Kowatch RA, Carmody T, Rush AJ (2005) Randomized, placebo-controlled trial of mixed amphetamine salts for symptoms of comorbid ADHD in pediatric bipolar disorder after mood stabilization with divalproex sodium. Am J Psychiatry 162: 58–64PubMedCrossRefGoogle Scholar
  50. 50.
    Findling RL, Short EJ, McNamara NK, Demeter CA, Stansbrey RJ, Gracious BL, Whipkey R, Manos MJ, Calabrese JR (2007) Methylphenidate in the treatment of children and adolescents with bipolar disorder and attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 46: 1445–1453PubMedCrossRefGoogle Scholar
  51. 51.
    Geller B, Cooper TB, Sun K, Zimerman B, Frazier J, Williams M, Heath J (1998) Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry 37: 171–178PubMedCrossRefGoogle Scholar

Copyright information

© Birkhäuser Verlag/Switzerland 2009

Authors and Affiliations

  • Robert L. Findling
    • 1
  1. 1.Departments of Psychiatry and PediatricsUniversity Hospitals Case Medical Center/Case Western Reserve UniversityClevelandUSA

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