Psychopharmacology of pediatric bipolar disorder: A review

Sylvester Smarty, Robert L Findling

Research output: Contribution to journalArticle

Abstract

Rationale: Pediatric bipolar disorder (PBD) is a chronic and debilitating psychiatric illness. It is associated with many short-term and long-term complications including poor academic and social performance, legal problems and increased risk of suicide. Moreover, it is often complicated by other serious psychiatric disorders including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and substance use disorders. For these reasons, there is a need for effective treatment for PBD. Objectives: To review available data from published reports of the treatment of PBD, highlighting those treatment practices for which there is scientific evidence. To suggest directions for future research. Materials and methods: A comprehensive Medline search was performed to identify published reports from 1995 to 2006. Reports with the greatest methodological stringency received greater focus. Results: There is limited evidence from double-blind, placebo-controlled trials regarding the treatment of PBD. Available data suggests that lithium, some anticonvulsants and second-generation antipsychotics may be equally beneficial in the acute monotherapy for youth with mixed or manic states. However, because of limited response to acute monotherapy, there is increased justification for combination therapy. There is very limited data on the treatment of the depressed phase of bipolar illness in the youth. Also, very few studies have addressed the treatment of comorbidities and maintenance/relapse prevention in PBD. Conclusion: Although significant progress was made in the treatment of youth with bipolar disorder, there is a need for more methodologically stringent research to more precisely define evidence-based treatment strategies for PBD.

Original languageEnglish (US)
Pages (from-to)39-54
Number of pages16
JournalPsychopharmacology
Volume191
Issue number1
DOIs
StatePublished - Mar 2007
Externally publishedYes

Fingerprint

Psychopharmacology
Bipolar Disorder
Pediatrics
Therapeutics
Psychiatry
Attention Deficit and Disruptive Behavior Disorders
Conduct Disorder
Attention Deficit Disorder with Hyperactivity
Secondary Prevention
Lithium
Anticonvulsants
Suicide
Antipsychotic Agents
Substance-Related Disorders
Comorbidity
Placebos
Maintenance

Keywords

  • Adolescents
  • Anticonvulsants
  • Atypical antipsychotics
  • Bipolar disorder
  • Children
  • Lithium
  • Mania
  • Treatment

ASJC Scopus subject areas

  • Pharmacology

Cite this

Psychopharmacology of pediatric bipolar disorder : A review. / Smarty, Sylvester; Findling, Robert L.

In: Psychopharmacology, Vol. 191, No. 1, 03.2007, p. 39-54.

Research output: Contribution to journalArticle

@article{fe39b1da8b564e828be4b377fadd5001,
title = "Psychopharmacology of pediatric bipolar disorder: A review",
abstract = "Rationale: Pediatric bipolar disorder (PBD) is a chronic and debilitating psychiatric illness. It is associated with many short-term and long-term complications including poor academic and social performance, legal problems and increased risk of suicide. Moreover, it is often complicated by other serious psychiatric disorders including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and substance use disorders. For these reasons, there is a need for effective treatment for PBD. Objectives: To review available data from published reports of the treatment of PBD, highlighting those treatment practices for which there is scientific evidence. To suggest directions for future research. Materials and methods: A comprehensive Medline search was performed to identify published reports from 1995 to 2006. Reports with the greatest methodological stringency received greater focus. Results: There is limited evidence from double-blind, placebo-controlled trials regarding the treatment of PBD. Available data suggests that lithium, some anticonvulsants and second-generation antipsychotics may be equally beneficial in the acute monotherapy for youth with mixed or manic states. However, because of limited response to acute monotherapy, there is increased justification for combination therapy. There is very limited data on the treatment of the depressed phase of bipolar illness in the youth. Also, very few studies have addressed the treatment of comorbidities and maintenance/relapse prevention in PBD. Conclusion: Although significant progress was made in the treatment of youth with bipolar disorder, there is a need for more methodologically stringent research to more precisely define evidence-based treatment strategies for PBD.",
keywords = "Adolescents, Anticonvulsants, Atypical antipsychotics, Bipolar disorder, Children, Lithium, Mania, Treatment",
author = "Sylvester Smarty and Findling, {Robert L}",
year = "2007",
month = "3",
doi = "10.1007/s00213-006-0569-y",
language = "English (US)",
volume = "191",
pages = "39--54",
journal = "Psychopharmacology",
issn = "0033-3158",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - Psychopharmacology of pediatric bipolar disorder

T2 - A review

AU - Smarty, Sylvester

AU - Findling, Robert L

PY - 2007/3

Y1 - 2007/3

N2 - Rationale: Pediatric bipolar disorder (PBD) is a chronic and debilitating psychiatric illness. It is associated with many short-term and long-term complications including poor academic and social performance, legal problems and increased risk of suicide. Moreover, it is often complicated by other serious psychiatric disorders including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and substance use disorders. For these reasons, there is a need for effective treatment for PBD. Objectives: To review available data from published reports of the treatment of PBD, highlighting those treatment practices for which there is scientific evidence. To suggest directions for future research. Materials and methods: A comprehensive Medline search was performed to identify published reports from 1995 to 2006. Reports with the greatest methodological stringency received greater focus. Results: There is limited evidence from double-blind, placebo-controlled trials regarding the treatment of PBD. Available data suggests that lithium, some anticonvulsants and second-generation antipsychotics may be equally beneficial in the acute monotherapy for youth with mixed or manic states. However, because of limited response to acute monotherapy, there is increased justification for combination therapy. There is very limited data on the treatment of the depressed phase of bipolar illness in the youth. Also, very few studies have addressed the treatment of comorbidities and maintenance/relapse prevention in PBD. Conclusion: Although significant progress was made in the treatment of youth with bipolar disorder, there is a need for more methodologically stringent research to more precisely define evidence-based treatment strategies for PBD.

AB - Rationale: Pediatric bipolar disorder (PBD) is a chronic and debilitating psychiatric illness. It is associated with many short-term and long-term complications including poor academic and social performance, legal problems and increased risk of suicide. Moreover, it is often complicated by other serious psychiatric disorders including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and substance use disorders. For these reasons, there is a need for effective treatment for PBD. Objectives: To review available data from published reports of the treatment of PBD, highlighting those treatment practices for which there is scientific evidence. To suggest directions for future research. Materials and methods: A comprehensive Medline search was performed to identify published reports from 1995 to 2006. Reports with the greatest methodological stringency received greater focus. Results: There is limited evidence from double-blind, placebo-controlled trials regarding the treatment of PBD. Available data suggests that lithium, some anticonvulsants and second-generation antipsychotics may be equally beneficial in the acute monotherapy for youth with mixed or manic states. However, because of limited response to acute monotherapy, there is increased justification for combination therapy. There is very limited data on the treatment of the depressed phase of bipolar illness in the youth. Also, very few studies have addressed the treatment of comorbidities and maintenance/relapse prevention in PBD. Conclusion: Although significant progress was made in the treatment of youth with bipolar disorder, there is a need for more methodologically stringent research to more precisely define evidence-based treatment strategies for PBD.

KW - Adolescents

KW - Anticonvulsants

KW - Atypical antipsychotics

KW - Bipolar disorder

KW - Children

KW - Lithium

KW - Mania

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=33847165690&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33847165690&partnerID=8YFLogxK

U2 - 10.1007/s00213-006-0569-y

DO - 10.1007/s00213-006-0569-y

M3 - Article

C2 - 17093980

AN - SCOPUS:33847165690

VL - 191

SP - 39

EP - 54

JO - Psychopharmacology

JF - Psychopharmacology

SN - 0033-3158

IS - 1

ER -