Pharmacologic Treatment Options for Bipolar Disorder in Children and Adolescents

Research output: Contribution to journalReview article

Abstract

Purpose of review Bipolar disorder is a chronic and disabling condition that often presents in adolescence and leads to significant functional impairment, especially in the areas of emotional, cognitive, and social development. Pharmacotherapy is a vital component of the complex treatment of this disorder.The purpose of this review is to provide an overview of the available data on the management of bipolar disorder and the most common comorbid conditions in youth. Recent findings Several medications such as lithium and second-generation antipsychotics (risperidone, aripiprazole, olanzapine, quetiapine, and asenapine) are currently approved by the FDA for the management of acute mixed or manic phases of pediatric bipolar disorder. Very limited data are available on continuation treatment and management of depressive phases of bipolar disorder. There is some evidence that supports the use of a combination of an antipsychotic with lithium or an anticonvulsant for treatment of resistant cases. Summary Monotherapy with an atypical antipsychotic or lithium is the preferable initial treatment of acute manic or mixed episodes. The available evidence supports the use of an olanzapine/fluoxetine combination for the treatment of bipolar depression, which has also been approved by the FDA for this purpose. Additional studies are needed to evaluate safety and efficacy of psychopharmacological interventions, especially focusing on treatment of the depressive and maintenance phases of bipolar disorder.

Original languageEnglish (US)
Pages (from-to)303-318
Number of pages16
JournalCurrent Treatment Options in Psychiatry
Volume4
Issue number4
DOIs
StatePublished - Dec 1 2017

Fingerprint

Bipolar Disorder
Lithium
Antipsychotic Agents
olanzapine
Therapeutics
Risperidone
Anticonvulsants
Maintenance
Pediatrics
Safety
Drug Therapy

Keywords

  • Adolescents
  • Bipolar disorder
  • Children
  • Pediatric
  • Pharmacotherapy
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Pharmacologic Treatment Options for Bipolar Disorder in Children and Adolescents. / Stepanova, Ekaterina; Findling, Robert L.

In: Current Treatment Options in Psychiatry, Vol. 4, No. 4, 01.12.2017, p. 303-318.

Research output: Contribution to journalReview article

@article{5e1495f1b7c745118cfe1e554762ac1f,
title = "Pharmacologic Treatment Options for Bipolar Disorder in Children and Adolescents",
abstract = "Purpose of review Bipolar disorder is a chronic and disabling condition that often presents in adolescence and leads to significant functional impairment, especially in the areas of emotional, cognitive, and social development. Pharmacotherapy is a vital component of the complex treatment of this disorder.The purpose of this review is to provide an overview of the available data on the management of bipolar disorder and the most common comorbid conditions in youth. Recent findings Several medications such as lithium and second-generation antipsychotics (risperidone, aripiprazole, olanzapine, quetiapine, and asenapine) are currently approved by the FDA for the management of acute mixed or manic phases of pediatric bipolar disorder. Very limited data are available on continuation treatment and management of depressive phases of bipolar disorder. There is some evidence that supports the use of a combination of an antipsychotic with lithium or an anticonvulsant for treatment of resistant cases. Summary Monotherapy with an atypical antipsychotic or lithium is the preferable initial treatment of acute manic or mixed episodes. The available evidence supports the use of an olanzapine/fluoxetine combination for the treatment of bipolar depression, which has also been approved by the FDA for this purpose. Additional studies are needed to evaluate safety and efficacy of psychopharmacological interventions, especially focusing on treatment of the depressive and maintenance phases of bipolar disorder.",
keywords = "Adolescents, Bipolar disorder, Children, Pediatric, Pharmacotherapy, Treatment",
author = "Ekaterina Stepanova and Findling, {Robert L}",
year = "2017",
month = "12",
day = "1",
doi = "10.1007/s40501-017-0125-x",
language = "English (US)",
volume = "4",
pages = "303--318",
journal = "Current Treatment Options in Psychiatry",
issn = "2196-3061",
publisher = "Springer International Publishing AG",
number = "4",

}

TY - JOUR

T1 - Pharmacologic Treatment Options for Bipolar Disorder in Children and Adolescents

AU - Stepanova, Ekaterina

AU - Findling, Robert L

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Purpose of review Bipolar disorder is a chronic and disabling condition that often presents in adolescence and leads to significant functional impairment, especially in the areas of emotional, cognitive, and social development. Pharmacotherapy is a vital component of the complex treatment of this disorder.The purpose of this review is to provide an overview of the available data on the management of bipolar disorder and the most common comorbid conditions in youth. Recent findings Several medications such as lithium and second-generation antipsychotics (risperidone, aripiprazole, olanzapine, quetiapine, and asenapine) are currently approved by the FDA for the management of acute mixed or manic phases of pediatric bipolar disorder. Very limited data are available on continuation treatment and management of depressive phases of bipolar disorder. There is some evidence that supports the use of a combination of an antipsychotic with lithium or an anticonvulsant for treatment of resistant cases. Summary Monotherapy with an atypical antipsychotic or lithium is the preferable initial treatment of acute manic or mixed episodes. The available evidence supports the use of an olanzapine/fluoxetine combination for the treatment of bipolar depression, which has also been approved by the FDA for this purpose. Additional studies are needed to evaluate safety and efficacy of psychopharmacological interventions, especially focusing on treatment of the depressive and maintenance phases of bipolar disorder.

AB - Purpose of review Bipolar disorder is a chronic and disabling condition that often presents in adolescence and leads to significant functional impairment, especially in the areas of emotional, cognitive, and social development. Pharmacotherapy is a vital component of the complex treatment of this disorder.The purpose of this review is to provide an overview of the available data on the management of bipolar disorder and the most common comorbid conditions in youth. Recent findings Several medications such as lithium and second-generation antipsychotics (risperidone, aripiprazole, olanzapine, quetiapine, and asenapine) are currently approved by the FDA for the management of acute mixed or manic phases of pediatric bipolar disorder. Very limited data are available on continuation treatment and management of depressive phases of bipolar disorder. There is some evidence that supports the use of a combination of an antipsychotic with lithium or an anticonvulsant for treatment of resistant cases. Summary Monotherapy with an atypical antipsychotic or lithium is the preferable initial treatment of acute manic or mixed episodes. The available evidence supports the use of an olanzapine/fluoxetine combination for the treatment of bipolar depression, which has also been approved by the FDA for this purpose. Additional studies are needed to evaluate safety and efficacy of psychopharmacological interventions, especially focusing on treatment of the depressive and maintenance phases of bipolar disorder.

KW - Adolescents

KW - Bipolar disorder

KW - Children

KW - Pediatric

KW - Pharmacotherapy

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=85065161739&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065161739&partnerID=8YFLogxK

U2 - 10.1007/s40501-017-0125-x

DO - 10.1007/s40501-017-0125-x

M3 - Review article

AN - SCOPUS:85065161739

VL - 4

SP - 303

EP - 318

JO - Current Treatment Options in Psychiatry

JF - Current Treatment Options in Psychiatry

SN - 2196-3061

IS - 4

ER -