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Review

Pharmacologic treatment and management of bipolar disorder in adolescents

, &
Pages 1165-1179 | Received 18 Jan 2022, Accepted 26 May 2022, Published online: 22 Jun 2022

References

  • Kessler RC, Merikangas KR, Wang PS. Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century. Ann Rev Clin Psychol. 2007;3(1):137–158.
  • Bolton S, Warner J, Harriss E, et al. Bipolar disorder: trimodal age-at-onset distribution. Bipolar Disord. 2021 Jun;23(4):341–356.
  • Washburn JJ, West AE, Heil JA. Treatment of pediatric bipolar disorder: a review. Minerva Psichiatr. 2011;52(1):21–35.
  • Goldstein BI, Birmaher B, Carlson GA, et al. The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: knowledge to date and directions for future research. Bipolar Disord. 2017 Nov;19(7):524–543.
  • Blader JC, Carlson GA. Increased rates of bipolar disorder diagnoses among U.S. child, adolescent, and adult inpatients, 1996‐2004. Biol Psychiatry. 2007;62:107‐114.
  • Dubicka B, Carlson GA, Vail A, et al. Prepubertal mania: diagnostic differences between US and UK clinicians. Eur Child Adolesc Psychiatry. 2008;17:153‐161.
  • Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ. 2001 Aug 11;323(7308):334–336.
  • Dandash O, Yücel M, Daglas R, et al. Differential effect of quetiapine and lithium on functional connectivity of the striatum in first episode mania. Transl Psychiatry. 2018 Mar 6;8(1):59.
  • Hunt J, Birmaher B, Leonard H, et al. Irritability without elation in a large bipolar youth sample: frequency and clinical description. J Am Acad Child Adolesc Psychiatry. 2009 Jul;48(7):730–739.
  • Youngstrom EA, Danielson CK, Findling RL, et al. Factor structure of the Young Mania Rating Scale for use with youths ages 5 to 17 years. J Clin Child Adolesc Psychol. 2002 Dec;31(4):567–572.
  • Licht RW. Lithium: still a major option in the management of bipolar disorder. CNS Neurosci Ther. 2012 Mar;18(3):219–226.
  • Soares JC, Gershon S. The lithium ion: a foundation for psychopharmacological specificity. Neuropsychopharmacology. 1998 Sep;19(3):167–182.
  • Alda M. Lithium in the treatment of bipolar disorder: pharmacology and pharmacogenetics. Mol Psychiatry. 2015;20(6):661–670.
  • Briggs KT, Giulian GG, Li G, et al. A molecular model for lithium’s bioactive form. Biophys J. [2016 Jul 26];111(2):294–300.
  • El-Mallakh RS, Huff MO. Mood stabilizers and ion regulation. Harv Rev Psychiatry. 2001 Jan-Feb;9(1):23–32.
  • Findling RL, Frazier JA, Kafantaris V, et al. The Collaborative Lithium Trials (CoLT): specific aims, methods, and implementation. Child Adolesc Psychiatry Ment Health. [2008 Aug 12];2(1):21.
  • Food and Drug Administration. Center for drug evaluation and research; advancing health through innovation: 2018 new drug therapy approvals. 2018. https://www.fda.gov/media/121483/download cited 2021 Dec 4.
  • Findling RL, Kafantaris V, Pavuluri M, et al. Dosing strategies for lithium monotherapy in children and adolescents with bipolar I disorder. J Child Adolesc Psychopharmacol. 2011 Jun;21(3):195–205.
  • El-Mallakh RS, Barrett JL, Jed Wyatt R. The Na,K-ATPase hypothesis for bipolar disorder: implications of normal development. J Child Adolesc Psychopharmacol. 1993;3(1):37–52.
  • Findling RL, Robb A, McNamara NK, et al. Lithium in the acute treatment of Bipolar I disorder: a Double-Blind, Placebo-Controlled Study. Pediatrics. 2015;136(5):885–894.
  • Findling RL, Kafantaris V, Pavuluri M, et al. Post-acute effectiveness of lithium in pediatric bipolar I disorder. J Child Adolesc Psychopharmacol. 2013 Mar;23(2):80–90.
  • Geller B, Cooper TB, Sun K, et al. Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry. 1998;37(2):171–178.
  • Kafantaris V, Coletti DJ, Dicker R, et al. Lithium treatment of acute mania in adolescents: a placebo-controlled discontinuation study. J Am Acad Child Adolesc Psychiatry. 2004 Aug;43(8):984–993.
  • Wagner KD, Weller EB, Carlson GA, et al. An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2002 Oct;41(10):1224–1230.
  • Delbello MP, Kowatch RA, Adler CM, et al. A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2006 Mar;45(3):305–313.
  • Pavuluri MN, Henry DB, Carbray JA, et al. Divalproex sodium for pediatric mixed mania: a 6-month prospective trial. Bipolar Disord. 2005 Jun;7(3):266–273.
  • Delbello MP, Findling RL, Kushner S, et al. A pilot controlled trial of topiramate for mania in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005 Jun;44(6):539–547.
  • Wagner KD, Kowatch RA, Emslie GJ, et al. A double-blind, randomized, placebo-controlled trial of oxcarbazepine in the treatment of bipolar disorder in children and adolescents. Am J Psychiatry. 2006 Jul;163(7):1179–1186. Erratum in: Am J Psychiatry. 2006 Oct;163(10):1843
  • Vasudev A, Macritchie K, Vasudev K, et al. Oxcarbazepine for acute affective episodes in bipolar disorder. Cochrane Database Syst Rev. 2011 Dec 7;12(12):CD004857.
  • Wagner KD, Redden L, Kowatch RA, et al. A double-blind, randomized, placebo-controlled trial of divalproex extended-release in the treatment of bipolar disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2009 May;48(5):519–532.
  • Singh RK, Sinha VK, Chaudhury S. Effect size of lithium, carbamazepine, and sodium valproate in child and adolescent bipolar 1 disorder during manic phase: a prospective open-label study. Industrial Psychiatry J. 2019Jul-Dec;28(2):185–197.
  • Mahmoudi-Gharaei J, Shahrivar Z, Faghihi T, et al. Topiramate versus valproate sodium as adjunctive therapies to a combination of lithium and risperidone for adolescents with bipolar i disorder: effects on weight and serum lipid profiles. Iran J Psychiatry. 2012;7(1):1–10. Winter.
  • Kowatch RA, Suppes T, Carmody TJ, et al. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2000 Jun;39(6):713–720.
  • Tramontina S, Zeni CP, Pheula G, et al. Topiramate in adolescents with juvenile bipolar disorder presenting weight gain due to atypical antipsychotics or mood stabilizers: an open clinical trial. J Child Adolesc Psychopharmacol. 2007 Feb;17(1):129–134.
  • Aparasu RR, Bhatara V. Antipsychotic prescribing trends among youths, 1997-2002. Psychiatr Serv. 2005 Aug;56(8):904.
  • Rhee TG, Olfson M, Nierenberg AA, et al. 20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings. Am J Psychiatry. [2020 Aug 1];177(8):706–715.
  • Schneider C, Taylor D, Zalsman G, et al. Antipsychotics use in children and adolescents: an on-going challenge in clinical practice. J Psychopharmacol. 2014 Jul;28(7):615–623.
  • Klassen TP, Hartling L, Hamm M, et al. StaR child health: an initiative for RCTs in children. Lancet. 2009 Oct 17;374:1310–1312.
  • March JS, Silva SG, Compton S, et al. The child and adolescent psychiatry trials network (CAPTN). J Am Acad Child Adolesc Psychiatry. 2004;43:515–518.
  • Burris KD, Molski TF, Xu C, et al. Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors. J Pharmacol Exp Ther. 2002 Jul;302(1):381–389.
  • Tramontina S, Zeni CP, Ketzer CR, et al. Aripiprazole in children and adolescents with bipolar disorder comorbid with attention-deficit/hyperactivity disorder: a pilot randomized clinical trial. J Clin Psychiatry. [2009 Apr 21];70(5):756–764.
  • Findling RL, Nyilas M, Forbes RA, et al. Acute treatment of pediatric bipolar I disorder, manic or mixed episode, with aripiprazole: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2009 Oct;70(10):1441–1451.
  • McIntyre RS. Pharmacology and efficacy of asenapine for manic and mixed states in adults with bipolar disorder. Expert Rev Neurother. 2010 May;10(5):645–649.
  • Findling RL, Landbloom RL, Szegedi A, et al. Asenapine for the acute treatment of pediatric manic or mixed episode of Bipolar I disorder. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):1032–1041.
  • Tohen M, Kryzhanovskaya L, Carlson G, et al. Olanzapine versus placebo in the treatment of adolescents with bipolar mania. Am J Psychiatry. 2007 Oct;164(10):1547–1556.
  • CM B Jr, Tollefson GD, Tran PV. Safety of olanzapine. J Clin Psychiatry. 1997;58(suppl 10):13–17.
  • Findling RL. Use of quetiapine in children and adolescents. J Clin Psychiatry. 2002;63(suppl 13):27–31.
  • Winter HR, Earley WR, Hamer-Maansson JE, et al. Steady-state pharmacokinetic, safety, and tolerability pro- files of quetiapine, norquetiapine, and other quetiapine metabo- lites in pediatric and adult patients with psychotic disorders. J Child Adolesc Psychopharmacol. 2008;18:81–98.
  • Pathak S, Findling RL, Earley WR, et al. Efficacy and safety of quetiapine in children and adolescents with mania associated with bipolar I disorder: a 3-week, double-blind, placebo-controlled trial. J Clin Psychiatry. 2013 Jan;74(1):e100–9. Well done randomized, placebo. Well done randomized, placebocontrolled trial of quetiapine in mania
  • Habibi N, Dodangi N, Nazeri A. Comparison of the effect of lithium plus quetiapine with lithium plus risperidone in children and adolescents with bipolar I disorder: a randomized clinical trial. Med J Islam Repub Iran. 2017 Mar 1;31:16.
  • Nyberg S, Farde L, Eriksson L, et al. 5-HT2 and D2 dopamine receptor occupancy in the living human brain. A PET study with risperidone. Psychopharmacology (Berl). 1993;110(3):265–272.
  • Haas M, Delbello MP, Pandina G, et al. Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study. Bipolar Disord. 2009 Nov;11(7):687–700.
  • Pavuluri MN, Henry DB, Findling RL, et al. Double-blind randomized trial of risperidone versus divalproex in pediatric bipolar disorder. Bipolar Disord. 2010 Sep;12(6):593–605.
  • Keck PE Jr., Versiani M, Potkin S, et al. Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double-blind, randomized trial. Am J Psychiatry. 2003;160:741–748.
  • Findling RL, Cavuş I, Pappadopulos E, et al. Efficacy, long-term safety, and tolerability of ziprasidone in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2013a Oct;23(8):545–557.
  • Findling RL, Cavuş I, Pappadopulos E, et al. Ziprasidone in adolescents with schizophrenia: results from a placebo-controlled efficacy and long-term open-extension study. J Child Adolesc Psychopharmacol. 2013b Oct;23(8):531–544.
  • Hughes T, Cardno A, West R, et al. Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study. Br J Gen Pract. 2016 Feb;66(643):e71–7.
  • Diler RS, Goldstein TR, Hafeman D, et al. Distinguishing bipolar depression from unipolar depression in youth: preliminary findings. J Child Adolesc Psychopharmacol. 2017 May;27(4):310–319.
  • Stawicka E, Wolańczyk T. Mania induced by antidepressants - characteristics and specific phenomena in children and adolescents. Psychiatr Pol. 2020 Jun 30;54(3):525–536. Discusses problems with antidepressants in children with bipolar.
  • Perugi G, Micheli C, Akiskal HS, et al. Polarity of the first episode, clinical characteristics, and course of manic depressive illness: a systematic retrospective investigation of 320 bipolar I patients. Compr Psychiatry. 2000 Jan-Feb;41(1):13–18.
  • Lee TT, Demick DS, Worthington MA, et al. The short form of the serotonin transporter and the safety of antidepressants when administered to pediatric populations. Current Trends Neurol. 2020;14. 73–83.
  • Inal N, Ermis C, Koc D, et al. Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder. Acta Psychiatr Scand . 2021 Jun 2;145(2): 200–208.
  • Horisawa T, Ishiyama T, Ono M, et al. Binding of lurasidone, a novel antipsychotic, to rat 5-HT7 receptor: analysis by [3H]SB-269970 autoradiography. Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jan 10;40:132–137.
  • Cates LN, Roberts AJ, Huitron-Resendiz S, et al. Effects of lurasidone in behavioral models of depression. Role of the 5-HT₇ receptor subtype. Neuropharmacology. 2013;70:211–217.
  • Loebel A, Xu J, Hsu J, et al. The development of lurasidone for bipolar depression. Ann N Y Acad Sci. 2015 ;1358:95–104.
  • DelBello MP, Goldman R, Philips D, et al. Efficacy and safety of lurasidone in children and adolescents with Bipolar I depression: a Double-Blind, Placebo-Controlled Study. J Am Acad Child Adolesc Psychiatry. 2017;56(12):1015–1025.
  • Raison CL, Siu C, Pikalov A, et al. C-reactive protein and response to lurasidone treatment in children and adolescents with bipolar I depression: results from a placebo-controlled trial. Brain Behav Immun. 2020;84:269–274.
  • Detke HC, DelBello MP, Landry J, et al. Olanzapine/Fluoxetine combination in children and adolescents with bipolar I depression: a randomized, double-blind, placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2015;54(3):217–224.
  • J WD, DelBello MP, Landry J, et al. Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination. Child Adolesc Psychiatry Ment Health. 2017;11:34.
  • DelBello MP, Chang K, Welge JA, et al. A double-blind, placebo-controlled pilot study of quetiapine for depressed adolescents with bipolar disorder. Bipolar Disord. 2009;11(5):483–493.
  • Findling RL, Pathak S, Earley WR, et al. Efficacy and safety of extended-release quetiapine fumarate in youth with bipolar depression: an 8 week, double-blind, placebo-controlled trial. J Child Adolesc Psychopharmacol. 2014;24(6):325–335.
  • Chang K, Delbello M, Chu WJ, et al. Neurometabolite effects of response to quetiapine and placebo in adolescents with bipolar depression. J Child Adolesc Psychopharmacol. 2012 Aug;22(4):261–268.
  • Chang K, DelBello M, Garrett A, et al. Neurofunctional correlates of response to quetiapine in adolescents with bipolar depression. J Child Adolesc Psychopharmacol. 2018;28(6):379–386.
  • McNamara R, Strawm JR, Tallman MJ, et al. Effects of fish oil monotherapy on depression and prefrontal neurochemistry in adolescents at high risk for Bipolar I disorder: a 12-week placebo-controlled proton magnetic resonance spectroscopy trial. J Child Adolesc Psychopharmacol. 2020;30(5):293–305.
  • McNamara RK, Li W, Lei D, et al. Fish oil supplementation alters emotion-generated corticolimbic functional connectivity in depressed adolescents at high-risk for bipolar I disorder: a 12-week placebo-controlled fMRI trial. Bipolar Disord. 2021;24(2):161–170.
  • Masi G, Milone A, Scrinzi G, et al. Lithium treatment in bipolar adolescents: a follow-up naturalistic study. Neuropsychiatr Dis Treat. 2018 Oct 17;14:2749–2753.
  • Strober M, Morrell W, Lampert C, et al. Relapse following discontinuation of lithium maintenance therapy in adolescents with bipolar I illness: a naturalistic study. Am J Psychiatry. 1990;147(4):457–461.
  • Findling RL, McNamara NK, Pavuluri M, et al. Lithium for the maintenance treatment of bipolar I disorder: a double-blind, placebo-controlled discontinuation study. J Am Acad Child Adolesc Psychiatry. 2019;58(2):287–296 e284. Presents data regarding the efficacy of maintenance lithium treatment
  • Findling RL, McNamara NK, Youngstrom EA, et al. Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2008;44(5):409–417.
  • Findling RL, McNamara NK, Youngstrom EA, et al. Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005;44(5):409–417. Discusses equivallency of lithium and divalproex
  • Findling RL, Frazier TW, Youngstrom EA, et al. Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment of symptomatic youth at high risk for developing bipolar disorder. J Clin Psychiatry. 2007;68(5):781–788.
  • Findling RL, Chang K, Robb A, et al. Adjunctive maintenance lamotrigine for pediatric bipolar I disorder: a placebo-controlled, randomized withdrawal tudy. J Am Acad Child Adolesc Psychiatry. 2015 Dec;54(12):1020–1031.e3.
  • Berk M, Daglas R, Dandash O, et al. Quetiapine v. lithium in the maintenance phase following a first episode of mania: randomised controlled trial. Br J Psychiatry. 2017;210(6):413–421.
  • Findling RL, Correll CU, Nyilas M, et al. Aripiprazole for the treatment of pediatric bipolar I disorder: a 30-week, randomized, placebo-controlled study. Bipolar Disord. 2013 Mar;15(2):138–149.
  • Nelson RE, McAdam-Marx C, Evans ML, et al. Patent extension policy for paediatric indications: an evaluation of the impact within three drug classes in a state Medicaid programme. Appl Health Econ Health Policy. [2011 May 1];9(3):171–181.
  • Sharav VH. The impact of the food and drug administration modernization act on the recruitment of children for research. Ethical Hum Sci Serv. 2003 Summer;5(2):83–108.
  • Serra G, Uchida M, Battaglia C, et al. Pediatric mania: the controversy between euphoria and irritability. Curr Neuropharmacol. 2017 Apr;15(3):386–393.
  • Gracious BL, Findling RL, Seman C, et al. Elevated thyrotropin in bipolar youths prescribed both lithium and divalproex sodium. J Am Acad Child Adolesc Psychiatry. 2004;43(2)215–20.
  • Shulman KI, Almeida OP, Herrmann N, et al. Delphi survey of maintenance lithium treatment in older adults with bipolar disorder: an ISBD task force report. Bipolar Disord. 2019 Mar;21(2):117–123.
  • Wilting I, Heerdink ER, Mersch PP, et al. Association between lithium serum level, mood state, and patient-reported adverse drug reactions during long-term lithium treatment: a naturalistic follow-up study. Bipolar Disord. 2009 Jun;11(4):434–440.
  • Hsu CW, Carvalho AF, Tsai SY, et al. Lithium concentration and recurrence risk during maintenance treatment of bipolar disorder: multicenter cohort and meta-analysis. Acta Psychiatr Scand. 2021 Oct;144(4):368–378.
  • Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018 Mar;20(2):97–170.
  • Lähteenvuo M, Tanskanen A, Taipale H, et al. Real-world effectiveness of pharmacologic treatments for the prevention of rehospitalization in a finnish nationwide cohort of patients with bipolar disorder. JAMA Psychiatry. [2018 Apr 1];75(4):347–355.
  • Nierenberg AA, McElroy SL, Friedman ES, et al. Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder. J Clin Psychiatry. 2016 Jan;77(1):90–99.
  • Reich W, Neuman RJ, Volk HE, et al. Comorbidity between ADHD and symptoms of bipolar disorder in a community sample of children and adolescents. Twin Res Hum Genet. 2005 Oct;8(5):459–466.
  • Chen MH, Chen YS, Hsu JW, et al. Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study. Bipolar Disord. 2015 May;17(3):315–322.
  • Arnold LE, Mount K, Frazier T, et al. Pediatric bipolar disorder and ADHD: family history comparison in the LAMS clinical sample. J Affect Disord. [2012 Dec 10];141(2–3):382–389.
  • Post RM, Leverich GS, Kupka RW, et al. Early-onset bipolar disorder and treatment delay are risk factors for poor outcome in adulthood. J Clin Psychiatry. 2010 Jul;71(7):864–872.
  • El-Mallakh RS, Watkins J. Prolactin elevations and permeability glycoprotein. Prim Care Companion CNS Disord. 2019 May 16;21(3):18nr02412.
  • Schneider MR, Adler CM, Whitsel R, et al. The effects of ziprasidone on prefrontal and amygdalar activation in manic youth with bipolar disorder. Israel J Psychiatr Related Sci. 2012;49(2):112–120.
  • Findling RL, Youngstrom EA, Zhao J, et al. Respondent and item level patterns of response of aripiprazole in the acute treatment of pediatric bipolar I disorder. J Affect Disord. 2012 Dec 20;143(1–3):231–235.
  • Xiao L, Ganocy SJ, Findling RL, et al. Baseline characteristics and early response at week 1 predict treatment outcome in adolescents with bipolar manic or mixed episode treated with olanzapine: results from a 3-week, randomized, placebo-controlled trial. J Clin Psychiatry. 2017;78(9):e1158–e1166.
  • Lei D, Li W, Tallman MJ, et al. Changes in the brain structural connectome after a prospective randomized clinical trial of lithium and quetiapine treatment in youth with bipolar disorder. Neuropsychopharmacology. 2021 Jun;46(7):1315–1323.
  • Streicher JV, Wen H, Blom TJ, et al. A preliminary study of the effects of treatment with lithium versus quetiapine on attention of adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2020 Sep;30(7):465–469.
  • Delbello MP, Schwiers ML, Rosenberg HL, et al. A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2002 Oct;41(10):1216–1223.
  • Pavuluri MN, Passarotti AM, Fitzgerald JM, et al. Risperidone and divalproex differentially engage the fronto-striato-temporal circuitry in pediatric mania: a pharmacological functional magnetic resonance imaging study. J Am Acad Child Adolesc Psychiatry. 2012 Feb;51(2):157–170.e5.

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