Vol 2 - Iss 2 - Article - Hiatrogenic Mania in Pediatric Bipolar Disorder #89

Hiatrogenic Mania in Pediatric Bipolar Disorder Gianni L. Faedda, MD ‘Lucio Bini’ Mood Disorders Center, New York, NY Correspondence should be addressed to: Dr. Gianni Faedda 245 East 50th Street, Suite 2A New York, NY 10022-7752, US Tel: +1.212.644.3111 Fax: +1.212.644.3119 Email: Gianni.faedda@moodcenter.org Submitted to Aspects of Affect, November 2006 [2453 word text, 223 word abstract, 54 references, 1 Table] Abstract: Objectives: Pediatric Bipolar Disorder remains a controversial diagnosis, its diagnostic boundaries are debated and treatment studies are still scarce. Even more controversial is the use of Antidepressant (AD) in children with BD. Treatment with AD in adults has been associated with mania (treatment-emergent mania, TEM), increased cycling, and resistance to treatment with mood stabilizers. Several questions on the treatment of Bipolar Disorder in children await an answer: 1) Can mania be induced by antidepressants, and if so, how often? 2) What are the features of treatment-emergent mania? 3) Are there identifiable risk factors? 4) What is the diagnostic and prognostic value of TEM? Methodology: Studies assessing the potential risks associated with AD use in children with BD are reviewed, with special attention to the features of AD-induced mania, as well as possible predictors, and optimal treatment. Results: Only three published reports describe TEM in youths with BD. While rates of TEM vary according to study population and selection criteria, TEM seem to be a fairly common occurrence, exceeding rates of spontaneous manic conversion in children with depression or anxiety disorders, and have been associated with psychotic and violent behaviors. Conclusions: TEM occurs frequently in children with BD, with variable duration and severity reported. Data are scarce, mostly retrospective and uncontrolled. General guidelines for the use of antidepressants in children Bipolar Disorder are discussed. Keywords: adverse reaction, antidepressant, bipolar, depression, mania, treatment Details   Price: €10.00 Options   Quantity 1 (this product is downloadable)  Add to cart

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