Pharmacologic Treatment of Bipolar Disorder in Children and Adolescents

Goldstein, Benjamin I.; Sassi, Roberto; Diler, Rasim Somer

doi:10.1016/j.chc.2012.07.004

Cited by 41 publications

(20 citation statements)

References 142 publications

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“…125 An early observational study of continuation treatment with lithium found an increased risk of relapse among adolescents who were not treated with lithium following hospitalization for mania. 148 A subsequent study of children and adolescents with BD who had been stabilized on the combination of lithium and divalproex found a similar survival time to recurrence among those randomized to continuation treatment with monotherapy with lithium or divalproex.…”

Section: | Pharmacologic Treatmentmentioning

confidence: 99%

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

et al. 2017

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Objectives Over the past two decades, there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (ie, pediatric BD [PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Gold-standard pharmacologic trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (US vs elsewhere) and developmental (pediatric vs adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics.

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Section: | Pharmacologic Treatmentmentioning

confidence: 99%

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

et al. 2017

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“…Pharmacotherapy is the first-line treatment for PBD but is complicated by low response rates, poor tolerability 19 , and inability to address the full range of impairments associated with PBD. Thus, adjunctive psychosocial intervention is considered essential for effective treatment 20 .…”

Section: Introductionmentioning

confidence: 99%

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

West¹,

Weinstein²,

Peters³

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

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Objective Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD). The objective of this study was to compare the efficacy of adjunctive Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) to psychotherapy as usual (control) for mood symptom severity and global functioning in children with BD. Method Sixty-nine youth, aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) disorder were randomly assigned to CFF-CBT or control groups. Both treatments consisted of 12 weekly sessions followed by 6 monthly booster sessions delivered over a total of 9 months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (posttreatment), and week 39 (6-month follow-up). Results Participants in CFF-CBT attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared to the control in reducing parent-reported mania at posttreatment and depression symptoms at posttreatment and follow-up. Global functioning did not differ at posttreatment but was higher among CFF-CBT participants at follow-up. Conclusion CFF-CBT may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with BD.

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“…244,245 Unfortunately, antimanic SGAs (with the exception of ziprasidone) have been shown to negatively impact each of the MetS components in pharmacoepidemiological studies and in controlled trials. 56,240,246,247 Despite metabolic monitoring guidelines (ie, glucose, lipids, weight, blood pressure) for patients treated with SGAs from the American Diabetes Association/American Psychiatric Association 248 and the International Society for Bipolar Disorder, 249 adherence to these monitoring guidelines is poor, particularly among youth.…”

Section: Second-generation Antipsychotic Drugsmentioning

confidence: 99%

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

Goldstein¹,

Carnethon²,

Matthews³

et al. 2015

Circulation

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404

290

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Abstract-In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children andAdolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2)

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Pharmacologic Treatment of Bipolar Disorder in Children and Adolescents

Cited by 41 publications

References 142 publications

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

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