Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T09:21:34.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharmacological interventions for bipolar youth: Developmental considerations

Published online by Cambridge University Press:  25 October 2006

MELISSA P. DELBELLO  and
ROBERT A. KOWATCH
MELISSA P. DELBELLO
Affiliation:
University of Cincinnati College of Medicine
ROBERT A. KOWATCH
Affiliation:
University of Cincinnati College of Medicine
Get access Rights & Permissions [Opens in a new window]

Abstract

Despite the high prevalence rate, there have been relatively few controlled studies to systematically examine pharmacological treatments for children and adolescents with bipolar disorder. We review the differences in clinical characteristics between youth and adults with bipolar disorder and the extant literature of pharmacological treatments for children and adolescents with bipolar disorder, as well as discuss the effectiveness of pharmacological interventions for treating children and adolescents who are at familial risk for developing bipolar disorder. Although the number of controlled studies of youth with manic and mixed episodes is rapidly growing, there are few studies examining treatments for depression and the prevention of recurrent affective episodes in this population. Although children and adolescents with bipolar disorder commonly present with co-occurring psychiatric disorders, such as attention-deficit/hyperactivity disorder, there are limited data to guide the treatment of these patients. Recently, studies have begun to characterize prodromal manifestations of bipolar disorder and identify early intervention strategies for treating children and adolescents with an elevated risk for developing bipolar disorder.

Type
Research Article
Information
Development and Psychopathology , Volume 18 , Issue 4 , December 2006 , pp. 1231 - 1246
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Barzman, D. H., DelBello, M. P., Kowatch, R. A., Gernert, B., Fleck, D. E., Pathak, S., et al. (2004). The effectiveness and tolerability of aripiprazole for pediatric bipolar disorders: A retrospective chart review. Journal of Child and Adolescent Psychopharmacology, 14, 593–600.CrossRefGoogle Scholar
Barzman, D. H., DelBello, M. P., Kowatch, R. A., Warner, J., Rofey, D., Stanford, K., et al. (2005). Adjunctive topiramate in hospitalized children and adolescents with bipolar disorders. Journal of Child and Adolescent Psychopharmacology, 15, 931–937.CrossRefGoogle Scholar
Biederman, J. (2003). Open label study of risperidone in children with bipolar disorder. Poster presented at the 16th European College of Neuropsychopharmacology Congress, Prague, Czech Republic, September 20–24.
Biederman, J., Mick, E., Hammerness, P., Harpold, T., Aleardi, M., Dougherty, M., et al. (2005). Open-label, 8-week trial of olanzapine and risperidone for the treatment of bipolar disorder in preschool-age children. Biological Psychiatry, 58, 589–594.CrossRefGoogle Scholar
Biederman, J., Mick, E., Prince, J., Bostic, J. Q., Wilens, T. E., Spencer, T., et al. (1999). Systematic chart review of the pharmacologic treatment of comorbid attention deficit hyperactivity disorder in youth with bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 9, 247–256.CrossRefGoogle Scholar
Biederman, J., Mick, E., Spencer, T. J., Wilens, T. E., & Faraone, S. V. (2000). Therapeutic dilemmas in the pharmacotherapy of bipolar depression in the young. Journal of Child and Adolescent Psychopharmacology, 10, 185–192.CrossRefGoogle Scholar
Biederman, J., Mick, E., Wozniak, J., Aleardi, M., Spencer, T., & Faraone, S. V. (2005). An open-label trial of risperidone in children and adolescents with bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 15, 311–317.CrossRefGoogle Scholar
Bowden, C. L., Calabrese, J. R., Sachs, G., Yatham, L. N., Asghar, S. A., Hompland, M., et al. (2003). A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Archives in General Psychiatry, 60, 392–400.CrossRefGoogle Scholar
Bowden, C. L., & Karren, N. U. (2006). Anticonvulsants in bipolar disorder. Australian and New Zealand Journal of Psychiatry, 40, 386–393.CrossRefGoogle Scholar
Bowring, M. A., & Kovacs, M. (1992). Difficulties in diagnosing manic disorders among children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 611–614.CrossRefGoogle Scholar
Cade, J. F. (1949). Lithium salts in the treatment of psychotic excitement. Medical Journal of Australia, 36, 349–352.Google Scholar
Calabrese, J., Bowden, C., Sachs, G., Ascher, J., Monaghan, E., & Rudd, G. (1999). A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar i depression. Journal of Clinical Psychiatry, 60, 79–88.CrossRefGoogle Scholar
Calabrese, J. R., Keck, P. E., Jr., Macfadden, W., Minkwitz, M., Ketter, T. A., Weisler, R. H., et al. (2005). A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. American Journal of Psychiatry, 162, 1351–1360.CrossRefGoogle Scholar
Calabrese, J. R., Sullivan, J. R., Bowden, C. L., Suppes, T., Goldberg, J. F., Sachs, G. S., et al. (2002). Rash in multicenter trials of lamotrigine in mood disorders: Clinical relevance and management. Journal of Clinical Psychiatry, 63, 1012–1019.CrossRefGoogle Scholar
Carlson, P. J., Singh, J. B., Zarate, C. A., Jr., Drevets, W. C., & Manji, H. K. (2006). Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets. NeuroRx, 3, 22–41.CrossRefGoogle Scholar
Chang, K., Saxena, K., & Howe, M. (2006). An open-label study of lamotrigine adjunct or monotherapy for the treatment of adolescents with bipolar depression. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 298–304.CrossRefGoogle Scholar
Chang, K. D., Dienes, K., Blasey, C., Adleman, N., Ketter, T., & Steiner, H. (2003). Divalproex monotherapy in the treatment of bipolar offspring with mood and behavioral disorders and at least mild affective symptoms. Journal of Clinical Psychiatry, 64, 936–942.CrossRefGoogle Scholar
Chang, K. D., & Ketter, T. A. (2000). Mood stabilizer augmentation with olanzapine in acutely manic children. Journal of Child and Adolescent Psychopharmacology, 10, 45–49.CrossRefGoogle Scholar
Chen, G., & Manji, H. K. (2006). The extracellular signal-regulated kinase pathway: An emerging promising target for mood stabilizers. Current Opinion in Psychiatry, 19, 313–323.CrossRefGoogle Scholar
Ciraulo, D. A., Shader, R. J., Greenblatt, D. J., & Creelman, W. L. (Eds.). (1995). Drug interactions in psychiatry. Baltimore, MD: Williams & Wilkins.
Compton, M. T., & Nemeroff, C. B. (2000). The treatment of bipolar depression. Journal of Clinical Psychiatry, 61(Suppl. 9), 57–67.Google Scholar
Correll, C. U., Penzner, J. B., Parikh, U. H., Mughal, T., Javed, T., Carbon, M., et al. (2006). Recognizing and monitoring adverse events of second-generation antipsychotics in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 15, 177–206.CrossRefGoogle Scholar
Cueva, J. E., Overall, J. E., Small, A. M., Armenteros, J. L., Perry, R., & Campbell, M. (1996). Carbamazepine in aggressive children with conduct disorder: A double-blind and placebo-controlled study. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 480–490.CrossRefGoogle Scholar
Delbello, M. P., Findling, R. L., Kushner, S., Wang, D., Olson, W. H., Capece, J. A., et al. (2005). A pilot controlled trial of topiramate for mania in children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 539–547.CrossRefGoogle Scholar
DelBello, M. P., & Geller, B. (2001). Review of studies of child and adolescent offspring of bipolar parents. Bipolar Disorders, 3, 325–334.CrossRefGoogle Scholar
DelBello, M. P., Kowatch, R. A., Adler, C. M., Stanford, K. E., Welge, J. A., Barzman, D. H., et al. (2006). A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania Journal of the American Academy of Child & Adolescent Psychiatry, 45.Google Scholar
DelBello, M. P., Kowatch, R. A., Warner, J., Schwiers, M. L., Rappaport, K. B., Daniels, J. P., et al. (2002a). Adjunctive topiramate treatment for pediatric bipolar disorder: A retrospective chart review. Journal of Child and Adolescent Psychopharmacology, 12, 323–330.Google Scholar
DelBello, M. P., Schwiers, M. L., Rosenberg, H. L., Strakowski, S. M., & Stephen, M. (2002b). A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1216–1223.Google Scholar
Delong, G. R., & Nieman, M. A. (1983). Lithium-induced behavior changes in children with symptoms suggesting manic-depressive illness. Psychopharmacology Bulletin, 19, 258–265.Google Scholar
Deltito, J. A., Levitan, J., Damore, J., Hajal, F., & Zambenedetti, M. (1998). Naturalistic experience with the use of divalproex sodium on an in-patient unit for adolescent psychiatric patients. Acta Psychiatrica Scandinavica, 97, 236–240.CrossRefGoogle Scholar
Einat, H., & Manji, H. K. (2006). Cellular plasticity cascades: Genes-to-behavior pathways in animal models of bipolar disorder. Biological Psychiatry, 59, 1160–1171.CrossRefGoogle Scholar
Evans, R. W., Clay, T. H., & Gualtieri, C. T. (1987). Carbamazepine in pediatric psychiatry. Journal of the American Academy of Child & Adolescent Psychiatry, 26, 2–8.CrossRefGoogle Scholar
Findling, R., Calabrese, J., & Youngstrom, E. (2003). Divalproex sodium vs. placebo in the treatment of youth at genetic high-risk for developing bipolar disorder. Bipolar Disorders, 5(Suppl. 1), 47.Google Scholar
Findling, R. L., & McNamara, N. K. (2004). Atypical antipsychotics in the treatment of children and adolescents: Clinical applications. Journal of Clinical Psychiatry, 65(Suppl. 6), 30–44.Google Scholar
Findling, R. L., McNamara, N. K., Gracious, B. L., Youngstrom, E. A., Stansbrey, R. J., Reed, M. D., et al. (2003). Combination lithium and divalproex sodium in pediatric bipolarity. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 895–901.CrossRefGoogle Scholar
Findling, R. L., McNamara, N. K., Stansbrey, R., Gracious, B. L., Whipkey, R. E., Demeter, C. A., et al. (2006). Combination lithium and divalproex sodium in pediatric bipolar symptom re-stabilization. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 142–148.CrossRefGoogle Scholar
Findling, R. L., McNamara, N. K., Youngstrom, E. A., Stansbrey, R., Gracious, B. L., Reed, M. D., et al. (2005). Double-blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 409–417.CrossRefGoogle Scholar
Frazier, J., Meyer, M., Biederman, J., Wozniak, J., Wilens, T., Spencer, T., et al. (1999). Risperidone treatment for juvenile bipolar disorder: A retrospective chart review. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 960–965.CrossRefGoogle Scholar
Geller, B., Bolhofner, K., Craney, J., Williams, M., Del, B. M., & Gundersen, K. (2000). Psychosocial functioning in a prepubertal and early adolescent bipolar disorder phenotype. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1543–1548.CrossRefGoogle Scholar
Geller, B., Cooper, T. B., Sun, K., Zimerman, M. A., Frazier, J., Williams, M., et al. (1998). Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 171–178.CrossRefGoogle Scholar
Geller, B., Cooper, T. B., Zimerman, B., Frazier, J., Williams, M., Heath, J., et al. (1998). Lithium for prepubertal depressed children with family history predictors of future bipolarity: A double-blind, placebo-controlled study. Journal of Affective Disorders, 51, 165–175.CrossRefGoogle Scholar
Geller, B., & Luby, J. (1997). Child and adolescent bipolar disorder: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1168–1176.CrossRefGoogle Scholar
Geller, B., Tillman, R., Craney, J. L., & Bolhofner, K. (2004). Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Archives of General Psychiatry, 61, 459–467.CrossRefGoogle Scholar
Geller, B., Zimerman, B., Williams, M., Bolhofner, K., Craney, J., Delbello, M., et al. (2000). Diagnostic characteristics of 93 cases of a prepubertal and early adolescent bipolar disorder phenotype by gender, puberty and comorbid attention deficit hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 10, 157–164.CrossRefGoogle Scholar
Goldstein, T. R., Birmaher, B., Axelson, D., Ryan, N. D., Strober, M. A., Gill, M. K., et al. (2005). History of suicide attempts in pediatric bipolar disorder: Factors associated with increased risk. Bipolar Disorders, 7, 525–535.CrossRefGoogle Scholar
Gram, L. F., & Rafaelsen, O. J. (1972). Lithium treatment of psychotic children and adolescents. A controlled clinical trial. Acta Psychiatrica Scandinavica, 48, 253–260.CrossRefGoogle Scholar
Hoopes, S. P., Reimherr, F. W., Hedges, D. W., Rosenthal, N. R., Kamin, M., Karim, R., et al. (2003). Treatment of bulimia nervosa with topiramate in a randomized, double-blind, placebo-controlled trial, part 1: Improvement in binge and purge measures. Journal of Clinical Psychiatry, 64, 1335–1341.CrossRefGoogle Scholar
Isaac, G. (1992). Misdiagnosed bipolar disorder in adolescents in a special educational school and treatment program. Journal of Clinical Psychiatry, 53, 133–136.Google Scholar
Isaac, G. (1995). Is bipolar disorder the most common diagnostic entity in hospitalized adolescents and children? Adolescence, 30, 273–276.Google Scholar
Isojarvi, J. I., Laatikainen, T. J., Pakarinen, A. J., Juntunen, K. T., & Myllyla, V. V. (1993). Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. New England Journal of Medicine, 329, 1383–1388.CrossRefGoogle Scholar
Joffe, H., Cohen, L. S., Suppes, T., McLaughlin, W. L., Lavori, P., Adams, J. M., et al. (2006). Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder. Biological Psychiatry, 59, 1078–1086.CrossRefGoogle Scholar
Johnson, B. A., Ait-Daoud, N., Bowden, C. L., DiClemente, C. C., Roache, J. D., Lawson, K., et al. (2003). Oral topiramate for treatment of alcohol dependence: A randomised controlled trial. Lancet, 361, 1677–1685.CrossRefGoogle Scholar
Kafantaris, V., Campbell, M., Padron-Gayol, M. V., Small, A. M., Locascio, J. J., & Rosenberg, C. R. (1992). Carbamazepine in hospitalized aggressive conduct disorder children: An open pilot study. Psychopharmacology Bulletin, 28, 193–199.Google Scholar
Kafantaris, V., Coletti, D. J., Dicker, R., Padula, G., & Kane, J. M. (2001). Adjunctive antipsychotic treatment of adolescents with bipolar psychosis. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 1448–1456.Google Scholar
Kafantaris, V., Coletti, D. J., Dicker, R., Padula, G., Pleak, R. R., & Alvir, J. M. (2004). Lithium treatment of acute mania in adolescents: A placebo-controlled discontinuation study. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 984–993.Google Scholar
Kastner, F. (1992). Verapamil and valproic acid treatment of prolonged mania. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 271–275.Google Scholar
Kastner, T., Friedman, D. L., Plummer, A. T., Ruiz, M. Q., & Henning, D. (1990). Valproic acid for the treatment of children with mental retardation and mood symptomatogy. Pediatrics, 86, 467–472.Google Scholar
Keck, P. E., Jr., Strawn, J. R., & McElroy, S. L. (2006). Pharmacologic treatment considerations in co-occurring bipolar and anxiety disorders. Journal of Clinical Psychiatry, 67(Suppl. 1), 8–15.Google Scholar
Ketter, T. A., Wang, P. W., Becker, O. V., Nowakowska, C., & Yang, Y. S. (2003). The diverse roles of anticonvulsants in bipolar disorders. Annals of Clinical Psychiatry, 15, 95–108.Google Scholar
Ketter, T. A., Wang, P. W., Nowakowska, C., & Marsh, W. K. (2004). New medication treatment options for bipolar disorders. Acta Psychiatrica Scandinavica, 110(Suppl. 422), 18–33.Google Scholar
Khouzam, H., & El-Gabalawi, F. (2000). Treatment of bipolar I disorder in an adolescent with olanzapine. Journal of Child and Adolescent Psychopharmacology, 10, 147–151.Google Scholar
Kovacs, M., & Pollock, M. (1995). Bipolar disorder and comorbid conduct disorder in childhood and adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 715–723.Google Scholar
Kowatch, R. A., & DelBello, M. P. (2005). Pharmacotherapy of children and adolescents with bipolar disorder. Psychiatric Clinics of North America, 28, 385–397.Google Scholar
Kowatch, R. A., & DelBello, M. P. (2006). Pediatric bipolar disorder: Emerging diagnostic and treatment approaches. Child and Adolescent Psychiatric Clinics of North America, 15, 73–108.Google Scholar
Kowatch, R. A., Fristad, M. A., Birmaher, B., Wagner, K. D., Findling, R. L., & Hellander, M. (2005). Treatment guidelines for children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 213–235.Google Scholar
Kowatch, R. A., Suppes, T., Carmody, T. J., Bucci, J. P., Hume, J. H., Kromelis, M., et al. (2000). Effect size of lithium, divalproex sodium and carbamazepine in children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 713–720.Google Scholar
Kowatch, R. A., Suppes, T., Gilfillan, S. K., Fuentes, R. M., Bruce D. Grannemann, M.S., et al. (1995). Clozapine treatment of children and adolescents with bipolar disorder and schizophrenia: A clinical case series. Journal of Child and Adolescent Psychopharmacology, 5, 241–253.Google Scholar
Lena, B. (1979). Lithium in child and adolescent psychiatry. Archives of General Psychiatry, 36(8 Spec No), 854–855.Google Scholar
Lewinsohn, P., Klein, D., & Seeley, J. (2000). Bipolar disorder during adolescence and young adulthood in a community sample. Bipolar Disorder, 2 (Pt. 2), 281–293.Google Scholar
Lewinsohn, P. M., Klein, D. N., & Seeley, J. R. (1995). Bipolar disorders in a community sample of older adolescents: Prevalence, phenomenology, comorbidity, and course. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 454–463.Google Scholar
Lofthouse, N., & Fristad, M. A. (2004). Psychosocial interventions for children with early-onset bipolar spectrum disorder. Clinics of Child and Family Psychology Review, 7, 71–88.Google Scholar
McElroy, S., & Keck, P. J. (2000). Pharmacologic agents for the treatment of acute bipolar mania. Biological Psychiatry, 48, 539–557.Google Scholar
McElroy, S. L., Arnold, L. M., Shapira, N. A., Keck, P. E., Jr., Rosenthal, N. R., Karim, M. R., et al. (2003). Topiramate in the treatment of binge eating disorder associated with obesity: A randomized, placebo-controlled trial. American Journal of Psychiatry, 160, 255–261.Google Scholar
McElroy, S. L., Shapira, N. A., Arnold, L. M., Keck, P. E., Rosenthal, N. R., Wu, S. C., et al. (2004). Topiramate in the long-term treatment of binge-eating disorder associated with obesity. Journal of Clinical Psychiatry, 65, 1463–1469.Google Scholar
McElroy, S. L., Suppes, T., Keck, P. E., Jr., Black, D., Frye, M. A., Altshuler, L. L., et al. (2005). Open-label adjunctive zonisamide in the treatment of bipolar disorders: A prospective trial. Journal of Clinical Psychiatry, 66, 617–624.Google Scholar
McKnew, D. H., Cytryn, L., Buchsbaum, M. S., Hamovit, J., Lamour, M., Rappaport, J. L., et al. (1981). Lithium in children of lithium-responding parents. Psychological Research, 4, 171–180.Google Scholar
Messenheimer, J. A., & Guberman, A. H. (2000). Rash with lamotrigine: Dosing guidelines. Epilepsia, 41, 488.Google Scholar
Moore, C. M., Demopulos, C. M., Henry, M. E., Steingard, R. J., Zamvil, L., Katic, A., et al. (2002). Brain-to-serum lithium ratio and age: An in vivo magnetic resonance spectroscopy study. American Journal of Psychiatry, 159, 1240–1242.Google Scholar
O'Donovan, C., Kusumakar, V., Graves, G. R., & Bird, D. C. (2002). Menstrual abnormalities and polycystic ovary syndrome in women taking valproate for bipolar mood disorder. Journal of Clinical Psychiatry, 63, 322–330.Google Scholar
Pande, A. C., Crockatt, J. G., Janney, C. A., Werth, J. L., & Tsaroucha, G. (2000). Gabapentin in bipolar disorder: A placebo-controlled trial of adjunctive therapy. Bipolar Disorders, 2, 249–255.Google Scholar
Papatheodorou, G., & Kutcher, S. P. (1993). Divalproex sodium treatment in late adolescent and young adult acute mania. Psychopharmacology Bulletin, 29, 213–219.Google Scholar
Papatheodorou, G., Kutcher, S. P., Katic, M., & Szalai, J. P. (1995). The efficacy and safety of divalproex sodium in the treatment of acute mania in adolescents and young adults: An open clinical trial. Journal of Clinical Psychopharmacology, 15, 110–116.Google Scholar
Patel, N. C., DelBello, M. P., Bryan, H. S., Adler, C. M., Kowatch, R. A., Stanford, K., et al. (2006). Open-label lithium for the treatment of adolescents with bipolar depression. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 289–297.Google Scholar
Pavuluri, M. N., Birmaher, B., & Naylor, M. W. (2005). Pediatric bipolar disorder: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 846–871.Google Scholar
Pavuluri, M. N., Henry, D. B., Carbray, J. A., Sampson, G., Naylor, M. W., & Janicak, P. G. (2004). Open-label prospective trial of risperidone in combination with lithium or divalproex sodium in pediatric mania. Journal of Affective Disorders, 82(Suppl. 1), S103–S111.Google Scholar
Perlis, R. H., Miyahara, S., Marangell, L. B., Wisniewski, S. R., Ostacher, M., DelBello, M. P., et al. (2004). Long-term implications of early onset in bipolar disorder: Data from the first 1000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biological Psychiatry, 55, 875–881.Google Scholar
Perlis, R. H., Welge, J. A., Vornik, L. A., Hirschfeld, R. M., & Keck, P. E. (2006). Atypical antipsychotics in the treatment of mania: A meta-analysis of randomized, placebo-controlled trials. Journal of Clinical Psychiatry, 67, 509–516.Google Scholar
Puente, R. M. (1975). The use of carbamazepine in the treatment of behavioural disorders in children. In W. Birkmayer (Ed.), Epileptic seizures–behaviour–pain (pp. 243–252). Baltimore, MD: University Park Press.
Rasgon, N. (2004). The relationship between polycystic ovary syndrome and antiepileptic drugs: A review of the evidence. Journal of Clinical Psychopharmacology, 24, 322–334.Google Scholar
Scheffer, R. E., Kowatch, R. A., Carmody, T., & Rush, A. J. (2005). Randomized, placebo-controlled trial of mixed amphetamine salts for symptoms of comorbid ADHD in pediatric bipolar disorder after mood stabilization with divalproex sodium. American Journal of Psychiatry, 162, 58–64.Google Scholar
Soutullo, C., Sorter, M., Foster, K., McElroy, S., & Keck, P. (1999). Olanzapine in the treatment of adolescent acute mania: A report of seven cases. Journal of Affective Disorders, 53, 279–283.Google Scholar
Strober, M., Morrell, W., Lampert, C., & Burroughs, J. (1990). Relapse following discontinuation of lithium maintenance therapy in adolescents with bipolar I illness: A naturalistic study. American Journal of Psychiatry, 147, 457–461.Google Scholar
Tillman, R., & Geller, B. (2003). Definitions of rapid, ultrarapid, and ultradian cycling and of episode duration in pediatric and adult bipolar disorders: A proposal to distinguish episodes from cycles. Journal of Child and Adolescent Psychopharmacology, 13, 267–271.Google Scholar
Tohen, M., Kryzhanovskaya, L., Carlson, G., DelBello, M., Wozniak, J., Kowatch, R., et al. (2005). Olanzapine versus placebo in the treatment of acute mania in adolescents with bipolar disorder: Efficacy and safety results of a 3-week, randomized, double-blind study. Paper presented at the American College of Neuropharmacology, Waikoloa, Hawaii.
Versavel, M., DelBello, M., Ice, K., Kowatch, R., Keller, D., & Miceli, J. (2005). Ziprasidone dosing study in pediatric patients with bipolar disorder, schizophrenia, or schizoaffective disorder. Neuropsychopharmacology, 30(Suppl. 1), 122.Google Scholar
Wagner, K. D., Kowatch, R. A., Emslie, G. J., Findling, R. L., Wilens, T. E., McCague, K., et al. (2006). A double-blind, randomized, placebo-controlled trial of oxcarbazepine in the treatment of bipolar disorder in children and adolescents. American Journal of Psychiatry, 163, 1179–1186.Google Scholar
Wagner, K. D., Weller, E., Biederman, J., Carlson, G. A., Frazier, J., Wozniak, J., et al. (2002). An open-label trial of divalproex in children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1224–1230.Google Scholar
Weisler, R. H., Hirschfeld, R., Cutler, A. J., Gazda, T., Ketter, T. A., Keck, P. E., et al. (2006). Extended-release carbamazepine capsules as monotherapy in bipolar disorder: Pooled results from two randomised, double-blind, placebo-controlled trials. CNS Drugs, 20, 219–231.Google Scholar
West, K., & McElroy, S. L. (1995). Oral loading doses in the valproate treatment of adolescents with mixed bipolar disorder. Journal of Child and Adolescent Psychopharmacology, 5, 225–231.Google Scholar
West, S. A., Keck, P. E. J., McElroy, S. L., Strakowski, S. M., Minnery, K. L., McConville, B. J., et al. (1994). Open trial of valproate in the treatment of adolescent mania. Journal of Child and Adolescent Psychopharmacology, 4, 263–267.Google Scholar
West, S. A., McElroy, S. L., Strakowski, S. M., Keck, P. E., Jr., & McConville, B. J. (1995). Attention deficit hyperactivity disorder in adolescent mania. American Journal of Psychiatry, 152, 271–273.Google Scholar
Whittier, M. C., West, S. A., Galli, V. B., & Raute, N. J. (1995). Valproic acid for dysphoric mania in a mentally retarded adolescent. Journal of Clinical Psychiatry, 56, 590–591.Google Scholar
Wilens, T. E., Biederman, J., Kwon, A., Ditterline, J., Forkner, P., Moore, H., et al. (2004). Risk of substance use disorders in adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1380–1386.Google Scholar
Wozniak, J., & Biederman, J. (1997). Childhood mania: Insights into diagnostic and treatment issues. Journal of the Association for Academy Minority Physicians, 8, 78–84.Google Scholar
Wozniak, J., Biederman, J., Kiely, K., Ablon, J. S., Faraone, S. V., Mundy, E., et al. (1995). Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 867–876.Google Scholar
Wozniak, J., Biederman, J., & Richards, J. A. (2001). Diagnostic and therapeutic dilemmas in the management of pediatric-onset bipolar disorder. Journal of Clinical Psychiatry, 62(Suppl. 14), 10–15.Google Scholar
Youngerman, J., & Canino, I. A. (1978). Lithium carbonate use in children and adolescents. A survey of the literature. Archives of General Psychiatry, 35, 216–224.Google Scholar
Zarate, C. A., Jr., Singh, J., & Manji, H. K. (2006). Cellular plasticity cascades: Targets for the development of novel therapeutics for bipolar disorder. Biological Psychiatry, 59, 1006–1020.Google Scholar