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Risperidone Works Well for Partial or Non-responders to Initial Treatment of Early Age Mania

Risperidone Works Well for Partial or Non-responders to Initial Treatment of Early Age Mania

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Both the diagnosis and treatment of bipolar disorder in youth are still subject to debate. The Treatment of Early Age Mania (TEAM) study evaluated lithium, risperidone, and divalproex sodium in children with bipolar I disorder who were naïve to antimanic medication, or were partial or nonresponders to 1 of 3 study medications.

These TEAM study authors, led by John Walkup, MD of Weill Cornell Medical College and New York Presbyterian Hospital in New York, report on an evaluation of the benefits of either an add-on or switch of antimanic medications for an 8-week trial period in partial and nonresponders.

The randomized, controlled trial included 379 children between the ages of 6 and 15 years, median age 10, with DSM-IV bipolar I disorder (mixed or manic phase). For this report, 154 patients were either nonresponders or partial responders to 1 of the 3 study medications. The 89 nonresponders were randomly assigned to 1 of the other 2 antimanic medications and cross-tapered. The 65 partial responders were randomly assigned to 1 of 2 other antimanic medications as an add-on to their initial medication. Adverse event rates were reported only for the add-on group.

The results show that the response rate for children switched to risperidone was higher (47.6%) than for those switched to either lithium (12.8%) or divalproex (17.2%). The response rate for partial responders who added risperidone was higher (53.3%) than for those who added divalproex (no response) and trended higher for lithium (26.7%).

The adverse events in the add-on group were largely consistent with those known for the second medication, the authors note. Weight gain was observed for all add-on medications in virtually all patients. There was no evidence that the average weight gain was different by study medication for partial responders.

In conclusion, the authors state that risperidone appears more useful than lithium or divalproex for children with bipolar I disorder and other comorbid conditions who are non-responders or partial responders to an initial antimanic medication trial.

RESULT: The treatment of early age mania: outcomes for partial and non-responders to initial treatment. Journal of the American Academy of Child & Adolescent Psychiatry | Oct 7, 2015 (Free abstract. Full Text $12)

 

 

 

 
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