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Evid Based Mental Health 15:19 doi:10.1136/ebmental-2011-100281
  • Therapeutics

Review: second-generation antipsychotics improve response in paediatric bipolar disorder, but are associated with adverse events

Question

Question

What is the efficacy of antimanic pharmacotherapy for paediatric bipolar disorder?

Outcomes

Change in the Young Mania Rating Scale (YMRS) score; response as defined in the individual studies (typically defined as ≥50% decrease in YMRS score.

Methods

Design

Systematic review and meta-analysis.

Data sources

PubMed was searched from 1989 to 2010. Additionally, the references of all recent review articles on paediatric bipolar disorder were reviewed manually.

Study selection and analysis

Open-label studies and double blind randomised controlled trials published in English were included. Chart reviews and case reports were excluded. Combination treatment studies were limited to acute randomised clinical trials of no more than two medicines. If a study evaluated more than one therapeutic compound, each medicine studied was considered separately (ie, as separate studies). Studies on bipolar depression and any study that did not focus on antimanic agents were excluded. Pooled estimates of response rates were calculated for the open-label studies and randomised controlled trials (RCT), and OR for response were calculated using random effects meta-analysis for the RCTs.

Main results

The review found …