title: Effect of Tamoxifen and Lithium on Treatment of Acute Mania Symptoms in Children and Adolescents.
abstract: OBJECTIVE
  Many studies have supported the role of protein kinase C (PKC) inhibitors in the physiopathology and treatment of bipolar disorder in adults. Tamoxifen is one of the drugs with the effect of PKC inhibition. This study aimed to determine the effect of tamoxifen on the rate of improvement mania symptoms in the sample of children and adolescents with acute mania.
  
  
  METHODS
  In this randomized, placebo-controlled clinical trial study, registered in www.irct.ir with the code of IRCT201410126418N3, overall 44 patients with bipolar disorder with acute manic episode were randomly assigned into treatment and control groups. The serum levels of lithium and tamoxifen among the participants in the treatment groups were 0.8 -1.1 mg and 20-40 mg per day respectively. Serum level of lithium among participants in the control group was similar. The main comparisons were made based on the Young Mania Rating Scale (YMRS) and Children Depression Inventory (CDI) scores of the participants at baseline and at the end of each study week. The pharmacological side effects of serum level of lithium were examined weekly. Analysis of Covariance(ANCOVA) test was used for the statistical analysis.
  
  
  RESULTS
  There was no difference in the baseline score of YMRS and CDI in the treatment and control groups while a statistical significant difference (P < 0.05) in these scores was found between and within the groups.
  
  
  CONCLUSIONS
  The addition of tamoxifen to lithium causes a significant difference in reducing the symptoms of mania and depression in the treatment group compared to the control group.
authors.affiliation: Child Psychiatry Department, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Fallah
authors.affiliation: Child Psychiatry Department, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Sorror
authors.initials: S
authors.lastname: Arman
authors.affiliation: Child Psychiatrist, Isfahan university of medical sciences, Isfahan, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Najafi
authors.affiliation: Department of Psychology, Islamic Azad University, Sharekord Branch, Sharekord, Iran.
authors.forename: Bahar
authors.initials: B
authors.lastname: Shayegh
keywords: Children; Lithium; Mania; Protein Kinase C; Tamoxifen