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Atypical Antipsychotics Address Psychotic Symptoms in Paediatric Bipolar Disorder: Presented at AACAP

By Paula Moyer

MIAMI BEACH, FL -- October 27, 2003 -- Treatment of paediatric bipolar disorder with atypical antipsychotics such as risperidone (Risperdal) and olanzapine (Zyprexa) stabilizes mood and reduces psychotic symptoms, according to findings presented here October 17^th at the 50^th Anniversary Meeting of the American Academy of Child and Adolescent Psychiatry.

"Both of the atypical antipsychotic agents we used in this open trial were effective at reducing psychotic symptoms," said Erick Mick, ScD, a psychometrician, Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, in Boston, Massachusetts, Massachusetts.

To determine if there were any secondary benefits to treatment with atypical antipsychotics, particularly regarding psychotic behavior, in children and adolescents with early-onset bipolar disorder, Dr. Mick and colleagues conducted an 8-week study with 30 boys and 18 girls with bipolar disorder with manic episodes.

Patients were an average of 8.9 years old, 13 boys and 5 girls were treated with olanzapine, and 17 boys and 13 girls were treated with risperidone.

The investigators evaluated the patients' psychotic symptoms with the Brief Psychiatric Rating Scale (BPRS) and documented the medications' short-term efficacy and safety, as well as the time course to response.

They also documented a statistically significant reduction, averaging 12 points, on the BPRS at the end of the study compared to the baseline scores (F[2,119]= 34.1, P < .0001). There was no statistically significant difference in scores between patients treated with risperidone and those treated with olanzapine (t = -0.45, P = .6).

However, Dr. Mick said that a preliminary evaluation showed that the risperidone group had significant improvements in three subscales of the BPRS: thought disorder, anxiety/depression, and hostility (P < .001, P < .009, and P < .001, respectively).

However, Dr. Mick cautioned that the data are highly preliminary. Therefore, he suggested that investigators develop controlled studies that target more specifically the psychotic component of early-onset bipolar disorder.


[Study title: Treatment of Psychotic Symptoms in Children With Bipolar Disorder. Abstract C36]

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