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Safety considerations in the psychopharmacology of pediatric bipolar disorder.
Expert Opin Drug Saf. 2019 Sep; 18(9):777-794.EO

Abstract

Introduction: The standard of treatment of pediatric bipolar disorder (BPD) often requires life-long psychopharmacological management. Several pharmacological agents are approved by the US FDA for the treatment of pediatric BPD. However, each medication may cause adverse events (AEs). Provider awareness of AE profiles of common pharmacologic agents would serve to better inform patients and families in evaluating and selecting between treatment options. Areas covered: This review focuses on medications that, in our clinical experience, are commonly prescribed for youth with BPD and were evaluated in prospective clinical trials for the treatment of pediatric BPD. This paper highlights acute and long-term AEs described in these studies. Expert opinion: Most medications increase risk of AEs in youth with BPD. Treatment with lithium may lead to thyrotropin elevations, but generally does not cause significant weight gain. Divalproex may lead to weight gain; however, this finding was not consistent in comparison studies with lithium. Olanzapine, risperidone, quetiapine, and asenapine are associated with metabolic abnormalities and weight gain. Studies of ziprasidone, aripiprazole and lurasidone do not suggest significant metabolic AEs. More studies are needed to assess efficacy and safety of medications in managing pediatric BPD. Special focus on long-term maintenance trials is required to further identify long-term AEs in this population.

Authors+Show Affiliations

a Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore , USA.a Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore , USA.a Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore , USA.a Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore , USA.

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

31242784

Citation

Sun, Amanda Y., et al. "Safety Considerations in the Psychopharmacology of Pediatric Bipolar Disorder." Expert Opinion On Drug Safety, vol. 18, no. 9, 2019, pp. 777-794.
Sun AY, Woods S, Findling RL, et al. Safety considerations in the psychopharmacology of pediatric bipolar disorder. Expert Opin Drug Saf. 2019;18(9):777-794.
Sun, A. Y., Woods, S., Findling, R. L., & Stepanova, E. (2019). Safety considerations in the psychopharmacology of pediatric bipolar disorder. Expert Opinion On Drug Safety, 18(9), 777-794. https://doi.org/10.1080/14740338.2019.1637416
Sun AY, et al. Safety Considerations in the Psychopharmacology of Pediatric Bipolar Disorder. Expert Opin Drug Saf. 2019;18(9):777-794. PubMed PMID: 31242784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety considerations in the psychopharmacology of pediatric bipolar disorder. AU - Sun,Amanda Y, AU - Woods,Steven, AU - Findling,Robert L, AU - Stepanova,Ekaterina, Y1 - 2019/07/11/ PY - 2019/6/28/pubmed PY - 2019/9/5/medline PY - 2019/6/28/entrez KW - Safety KW - adverse events KW - anticonvulsants KW - antipsychotics KW - bipolar disorder KW - lithium KW - pediatric KW - treatment SP - 777 EP - 794 JF - Expert opinion on drug safety JO - Expert Opin Drug Saf VL - 18 IS - 9 N2 - Introduction: The standard of treatment of pediatric bipolar disorder (BPD) often requires life-long psychopharmacological management. Several pharmacological agents are approved by the US FDA for the treatment of pediatric BPD. However, each medication may cause adverse events (AEs). Provider awareness of AE profiles of common pharmacologic agents would serve to better inform patients and families in evaluating and selecting between treatment options. Areas covered: This review focuses on medications that, in our clinical experience, are commonly prescribed for youth with BPD and were evaluated in prospective clinical trials for the treatment of pediatric BPD. This paper highlights acute and long-term AEs described in these studies. Expert opinion: Most medications increase risk of AEs in youth with BPD. Treatment with lithium may lead to thyrotropin elevations, but generally does not cause significant weight gain. Divalproex may lead to weight gain; however, this finding was not consistent in comparison studies with lithium. Olanzapine, risperidone, quetiapine, and asenapine are associated with metabolic abnormalities and weight gain. Studies of ziprasidone, aripiprazole and lurasidone do not suggest significant metabolic AEs. More studies are needed to assess efficacy and safety of medications in managing pediatric BPD. Special focus on long-term maintenance trials is required to further identify long-term AEs in this population. SN - 1744-764X UR - https://www.unboundmedicine.com/medline/citation/31242784/Safety_considerations_in_the_psychopharmacology_of_pediatric_bipolar_disorder L2 - http://www.tandfonline.com/doi/full/10.1080/14740338.2019.1637416 DB - PRIME DP - Unbound Medicine ER -