A drug successfully used for decades in treating adults with bipolar disorder can also be safe and effective for children suffering from the same condition, a new multicenter study showed.
According to a new study published Oct. 12 in the journal Pediatrics and led by researchers from the Johns Hopkins Children’s Center, doctors can now confidently add lithium, one of the oldest medications for bipolar disorder in adults, to their roster of treatments in the short-term.
Bipolar disorder is a chronic condition marked by abnormally high moods and low moods - mania and depression - that occur spontaneously. Lithium has been established to help stabilize extreme mood swings in adults.
“[It] is the grandfather of all treatments for bipolar disorder, but it has never been rigorously studied in children,” revealed Dr. Robert Findling, study lead author and professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine.
The research team performed a randomized trial on 81 patients ranging from ages 7 to 17, all diagnosed with bipolar disorder. Post-“washout” period for those already getting ineffective drugs, 53 subjects started to take standard lithium doses (gradually increasing over the next eight weeks) while 28 received placebo.
Children on lithium significantly improved their symptoms, with some 47 percent scoring “Very Much Improved” or “Much Improved” on the Clinical Global Impressions Scale. Only 21 percent of those on placebo achieved the same results.
Lithium treatment was not linked to significant weight gain unlike therapy with antipsychotic agents such as risperidone or olanzapine, the researchers added. None of the patients also exhibited serious side effects.
Findling reported that further investigation is being done to examine lithium’s long-term effects, with a specific focus on potential side effects such as weight gain and diminished kidney or thyroid function.
Approximately one percent of teenagers are affected by bipolar disorder, usually starting during adolescence or the young adult phase.
Controversy has surrounded the diagnosis of bipolar disorder in children, with a 2007 study estimating that diagnoses in this group increased from 25 per 100,000 between 1994 and 1995 to 1,003 per 100,000 between 2002 and 2003.
Some experts believe the disorder is “both poorly defined and commonly known,” resulting in the sharply increasing misdiagnoses.
The Juvenile Bipolar Research Foundation noted that the dates in the said study fall before and after the new classification of the American Psychiatric Association of the disease, with BP-NOS (Bipolar Disorder Not Otherwise Specified) as the one given to most kids and teens.
BP-NOS is often treated exactly as bipolar disorder even though symptoms hardly match the criteria for the condition.
Lithium is classified by the National Library of Medicine as an anti-manic medication, decreasing abnormal brain activity. Suicide risks increase in patients with alternating mood cycles, or those who feel frenzied and then suddenly become depressed.
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