TABLE 10

Published Studies of Efficacy of Atypical Antipsychotics for Pediatric Bipolar Disorder

MedicationStudyAgesTypeResultsComments
AripiprazoleBarzman et al (2004)555–19; n = 30Chart reviewResponse rate 67%Bipolar or schizoaffective; adjunctive or monotherapy
AripiprazoleBiederman et al (2005)564–17; n = 41Records review71% improvement of manic symptomsAripiprazole alone and as add-on
AripiprazoleBiederman et al (2007)576–17; n = 19Open-label trialSignificant improvementMania
AripiprazoleTramontina et al (2007)588–17; n = 10Open-label trialSignificant improvementComorbid bipolar and ADHD; improved both mania and ADHD symptoms
AripiprazoleFindling et al (2009)5910–17; n = 296Double-blindSignificant response rate difference, 44% (10 mg), 64% (30 mg), 26% (placebo)Manic or mixed
AripiprazoleTramontina et al (2009)608–17; n = 43Double-blindSignificant response rate difference, 89% vs 52% of placebo groupManic or mixed comorbid with ADHD
ClozapineMasi et al (2002)6112–17; n = 10Open-label trialSignificant improvementSevere treatment-resistant manic or mixed
OlanzapineFrazier et al (2001)625–14; n = 23Open-label trialResponse rate 61%Acute mania
OlanzapineTohen et al (2007)6313–17; n = 161Double-blindSignificant response rate difference, 45% vs 19% of placebo groupAcute manic or mixed
OlanzapineJoshi et al (2010)644–17; n = 52Open-label trial; secondary analysis of 2 trialsSignificantly less antimanic response with comorbid OCDBipolar disorder
QuetiapineDel Bello et al (2007)6512–18; n = 20Single-blind, open labelResponse rate 87% with mood symptomsPatients at high risk for bipolar I
QuetiapineDel Bello et al (2009)6612–18; n = 32Double-blindNo significant difference from placeboBipolar depression
QuetiapineScheffer et al (2010)676–16; n = 75Open-label trial94% much improved at 8 wk; rapid loading tolerated wellBipolar disorder
RisperidoneFrazier et al (1999)684–17; n = 28Records reviewResponse rate 82% with manic and aggressive symptomsMixed or hypomanic
RisperidoneBiederman et al (2005)696–17; n = 30Open-label trialResponse rate 70% with manic symptomsManic, mixed, or hypomanic
RisperidoneHaas et al (2009)7010–17; n = 169Double-blindSignificant response rate difference, 59% (0.5–2.5 mg), 63% (3–6 mg), 26% (placebo)Acute manic or mixed
RisperidoneCarlson et al (2010)715–12; n = 151Chart reviewReduced duration or ragesHospitalized children with possible bipolar disorder
RisperidoneKrieger et al (2011)727–17; n = 21Open-label trialSignificant reduction of irritability, depression, ADHD symptoms, and global functioningSevere mood dysregulation
ZiprasidoneBiederman et al (2007)736–17; n = 21Open-label trialResponse rate 71% with manic symptomsMania