Robert A. Kowatch, MD, PhD, Professor of psychiatry and pediatrics, Director of psychiatry research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Jeffrey R. Strawn, MD, Clinical fellow, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Michael T. Sorter, MD, Associate professor of psychiatry and pediatrics, Director, division of psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Five recent randomized controlled trials (RCTs) have demonstrated the efficacy of atypical antipsychotics for treating bipolar disorder in children and adolescents, but 4 of these 5 trials remain unpublished. The lag time between the completion of these trials and publication of their results—typically 4 to 5 years—leaves psychiatrists without important evidence to explain to families and critics why they might recommend using these powerful medications in children with mental illness.
This article previews the preliminary results of these 5 RCTs of atypical antipsychotics, offers a treatment algorithm supported by this evidence, and discusses how to manage potentially serious risks when using antipsychotics to treat children and adolescents with bipolar disorder (BPD).