title: Combination pharmacotherapy in children and adolescents with bipolar disorder.
abstract: BACKGROUND
  The purpose of this study was to develop prospective data on the effectiveness of combination pharmacotherapy of children and adolescents with bipolar disorder during a 6-month period of prospective, semi-naturalistic treatment.
  
  
  METHODS
  Thirty-five subjects, with a mean age of 11 years, were treated in the extension phase of this study after having received 6-8 weeks of acute treatment with a single mood stabilizer. The extension phase of this study lasted for another 16 weeks, for a total of 24 weeks of prospective treatment. During this study phase, subjects were openly treated, and they could have their acute-phase mood stabilizer switched or augmented with another mood stabilizer, a stimulant, an antidepressant agent, or antipsychotic agent, if they were assessed to be a nonresponder to monotherapy with their initial mood stabilizer.
  
  
  RESULTS
  During the extension phase of treatment, 20 of 35 subjects (58%) required treatment with one or two mood stabilizers and either a stimulant, an atypical antipsychotic agent, or an antidepressant agent. The response rate to combination therapy was very good, with 80% of subjects treated responding to combination therapy with two mood stabilizers after not responding to monotherapy with a mood stabilizer.
  
  
  CONCLUSIONS
  This study suggests that children and adolescents with bipolar disorder are similar to adults with bipolar disorder, who also frequently require combination therapy.
authors.affiliation: Department of Psychiatry, Cincinnati Children's Hospital Medical Center and the University of Cincinnati Medical Center, Cincinnati, Ohio 45267, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kowatch
authors.forename: Gopalan
authors.initials: G
authors.lastname: Sethuraman
authors.forename: Judith H
authors.initials: JH
authors.lastname: Hume
authors.forename: Michelle
authors.initials: M
authors.lastname: Kromelis
authors.forename: Warren A
authors.initials: WA
authors.lastname: Weinberg
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000008:administration & dosage; D018692:Antimanic Agents / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy*; D016642:Bupropion / Q000627:therapeutic use; D002220:Carbamazepine / Q000008:administration & dosage*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008094:Lithium / Q000008:administration & dosage*; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage; D011446:Prospective Studies; D018967:Risperidone / Q000008:administration & dosage; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage; D014635:Valproic Acid / Q000008:administration & dosage*
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D016642:Bupropion; D002220:Carbamazepine; D000697:Central Nervous System Stimulants; D008094:Lithium; D008774:Methylphenidate; D018967:Risperidone; D017367:Selective Serotonin Reuptake Inhibitors; D014635:Valproic Acid