title: Aripiprazole in juvenile bipolar disorder comorbid with attention-deficit/hyperactivity disorder: an open clinical trial.
abstract: BACKGROUND
  Juvenile bipolar disorder (JBD) is a highly impairing chronic mental health condition that affects children and adolescents' overall functioning. Comorbidity with attention-deficit/hyperactivity disorder (ADHD) is extremely prevalent and may determine worse response to treatment. Few investigations have addressed the use of recent atypical antipsychotics in JBD, although several guidelines suggest their use.
  
  
  METHODS
  We conducted a 6-week open trial with aripiprazole in 10 children and adolescents with JBD comorbid with ADHD to assess impact on mania and ADHD symptoms, respectively, by means of the Young Mania Rating Scale and the Swanson, Nolan and Pelham Scale, as well as on global functioning (Clinical Global Impressions-Severity), and adverse events.
  
  
  RESULTS
  Significant improvement in global functioning scores (F=3.17, P=.01, effect size=0.55), manic symptoms (F=5.63, P<.01; ES=0.93), and ADHD symptoms (t=3.42, P<.01;ES=1.05) were detected. Although an overall positive tolerability was reported, significant weight gain (F=3.07, P=.05) was observed.
  
  
  CONCLUSIONS
  Aripiprazole was effective in improving mania and ADHD symptoms, but neither JBD nor ADHD symptom remission was observed in most of the cases. Randomized placebo-controlled trials for JBD and ADHD are needed.
authors.affiliation: Attention-Deficit/Hyoeractivity Disorder, Division of Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre at the Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
authors.forename: Silza
authors.initials: S
authors.lastname: Tramontina
authors.forename: Cristian Patrick
authors.initials: CP
authors.lastname: Zeni
authors.forename: Gabriel Ferreira
authors.initials: GF
authors.lastname: Pheula
authors.forename: Carla Ketzer
authors.initials: CK
authors.lastname: de Souza
authors.forename: Luis Augusto
authors.initials: LA
authors.lastname: Rohde
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D015363:Quinolones / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole