Onset of bipolar disorder during adolescence increases the risk of school failure, out-of-home placement, drug abuse and addiction, and suicide. In adolescents, bipolar disorder is often accompanied by delusions, hallucinations, or severe assaultive or destructive behaviors that require acute treatment with adjunctive antipsychotic medication in addition to a mood stabilizer. There are no data on when to withdraw antipsychotic medication or whether to withdraw it at all. Although it is important to identify patients who could be maintained on lithium alone to decrease the risk of developing long-term adverse effects such as tardive dyskinesia (TD), it is also important to prevent disruptive recurrences of episodes of illness. There is a high rate of failure on lithium maintenance treatment in general. For adolescents who have had psychotic features or assaultive, destructive behavior as part of their mania, continued adjunctive antipsychotic medication may offer additional prophylactic efficacy. In addition, a lower risk of TD with the novel antipsychotics may alter the risk: benefit ratio in favor of longer-term antipsychotic treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH060845-04
Application #
6737449
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Vitiello, Benedetto
Project Start
2001-03-01
Project End
2006-02-28
Budget Start
2004-03-01
Budget End
2005-02-28
Support Year
4
Fiscal Year
2004
Total Cost
$650,619
Indirect Cost
Name
Feinstein Institute for Medical Research
Department
Type
DUNS #
110565913
City
Manhasset
State
NY
Country
United States
Zip Code
11030
Correll, Christoph U; Hauser, Marta; Penzner, Julie B et al. (2014) Type and duration of subsyndromal symptoms in youth with bipolar I disorder prior to their first manic episode. Bipolar Disord 16:478-92
Kafantaris, Vivian; Kingsley, Peter; Ardekani, Babak et al. (2009) Lower orbital frontal white matter integrity in adolescents with bipolar I disorder. J Am Acad Child Adolesc Psychiatry 48:79-86