TABLE 9

Published Studies of Efficacy of Mood Stabilizers With Pediatric Bipolar Disordera

MedicationStudyAgesTypeResultsComments
DivalproexWagner et al (2002)417–19; n = 40Open-label trialResponse rate 61% with manic symptomsManic, mixed, or hypomanic
DivalproexHenry et al (2003)424–18; n = 15Records reviewResponse rate 53% after 1 yDivalproex alone and as add-on
DivalproexWagner et al (2009)4310–17; n = 150Double-blindNo significant difference from placeboManic or mixed
LamotrigineChang et al (2006)4412–17; n = 20Open-label trialSignificant decreases in depression, mania, and aggressionLamotrigine alone and in combination with other medication
LamotriginePavuluri et al (2009)458–18; n = 46Open-label trialResponse rate 72% with manic symptoms and 82% with depressive symptomsMonotherapy
LithiumStrober et al (1990)4613–17, n = 37Naturalistic prospective follow-upRelapse rate 3 times higher when lithium discontinuedLithium alone and in combination with other medication
LithiumGeller et al (1998)4712–18; n = 25Double-blindSignificant response rate difference, 46% versus 8% of placebo groupBipolar disorder with secondary substance dependence
LithiumKafantaris et al (2003)4812–18; n = 100Open-label trialResponse rate 63% with manic symptomsAcute mania
LithiumKafantaris, et al (2004)4912–18; n = 40Double-blind discontinuationNo significant difference from placeboMania with or without psychosis or aggression
LithiumPatel et al (2006)5012–18; n = 27Open-label trialResponse rate 48% with depressive symptomsAcute bipolar depression
OxcarbazepineWagner et al (2006)517–18; n = 116Double-blindNo significant difference from placeboManic or mixed
TopiramateDel Bello et al (2002)525–20; n = 26Chart reviewResponse rate 73% for mania and 62% for overall illnessOutpatient with acute manic, mixed, or depressive episode; adjunctive or monotherapy
TopiramateBarzman et al (2005)537–20; n = 25Chart reviewResponse rate 64%Hospitalized with acute manic, mixed, or depressive episode; adjunctive or monotherapy
TopiramateDelBello, et al (2005)546–17; n = 56Double-blindMixed resultsInconclusive; study stopped early when early adult studies failed to show efficacy
  • a Includes only the most recent studies of divalproex and lithium.