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Update on the treatment of bipolar disorder in children and adolescents

Published online by Cambridge University Press:  16 April 2020

Robert L. Findling
Robert L. Findling*
Affiliation:
Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH44106-5080, USA
*
*Corresponding author. E-mail address: Robert.Findling@uhhs.com (R.L. Findling).
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Abstract

As the phenomenology of pediatric bipolar disorder has become better delineated, clinicians are now able to more accurately assess and treat young people suffering from this condition. For pediatric patients with bipolar I disorder and symptoms of mania, medication monotherapy has been shown to lead to symptom amelioration. However, this treatment modality oftentimes does not lead to full symptom remission. In an attempt to address this observation, combination treatment strategies have recently been investigated. Recently, a maintenance study has shown that in youths who achieved remission on a combination of lithium and divalproate therapy, either of these agents alone was equally effective as a treatment strategy. In youths identified as being at genetic high risk for bipolarity who also had problematic affective symptomatology, treatment with divalproate was not found to be superior to placebo; however, those with the greatest degree of genetic risk for familial psychopathology remained in the trial longer than those with more modest amounts of familial psychopathology. These data suggest that intervention in youths with only one affected parent may not be a rational prevention strategy for pharmacological intervention in bipolar disorder, and that cohorts more genetically at risk may be a more appropriate group for preventative pharmacotherapy.

Keywords

AdolescentChildMood stabilizing agentsBipolar disorderTreatment
Type
Review
Information
European Psychiatry , Volume 20 , Issue 2 , March 2005 , pp. 87 - 91
Copyright
Copyright © Elsevier SAS 2005

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