Standby Drug for Adult Bipolar Disorder May Be Safe, Effective in Children

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A new study suggests that lithium — for years a go-to medication for adults with bipolar disorder — may be safely used in children with the condition, at least for the short term.

As the researchers explained, lithium has long been the drug of choice for treating adults with bipolar disorder, which is characterized by extreme mood swings. The condition affects about 1 percent of teens and is a leading cause of disability in the teenage years. Bipolar disorder typically begins in the teens or young adulthood, the researchers noted.

While lithium is a standby medication for adult patients, it has “never been rigorously studied in children,” lead researcher Dr. Robert Findling, a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine in Baltimore, said in a university news release.

To try and close that research gap, Findling’s group tracked outcomes for 81 young patients with bipolar disorder, aged 7 to 17, who were divided into two groups.

One group (53 patients) started taking a standard dose of lithium, gradually increasing to the maximum dose over eight weeks if their mood symptoms weren’t controlled. The other group (28 patients) took a placebo.

The patients who took lithium had much greater improvements in their symptoms than those who took the placebo. About 47 percent of those in the lithium group were “much improved” or “very much improved,” compared with 21 percent of those in the placebo group.

And unlike other psychiatric drugs such as risperidone or olanzapine, lithium was not associated with significant weight gain, the researchers found. As well, none of the patients taking lithium had serious drug-related side effects, the team said.

The study, published Oct. 12 in the journal Pediatrics, was funded by the U.S. National Institute of Child Health and Human Development.

The results can assist doctors when deciding what medication to prescribe for short-term treatment of children and teens with bipolar disorder, said Findling, who is also director of child and adolescent psychiatry at the Johns Hopkins Children’s Center.

The study was relatively short in duration, however, and Findling said that the effects of long-term use of lithium in youngsters are currently being assessed, including the risk of weight gain, and kidney and thyroid problems. A clearer understanding of the long-term impact of lithium use is crucial because some people with bipolar disorder require life-long medication, he said.

Dr. Victor Fornari directs child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y. He called the new study a “very important advance in the care of children with bipolar disorder.”

“Until this study, there was no data to support the use of lithium in the treatment of youth with biopolar disorder,” he said. “This study provides evidence to support the efficacy and benefit of lithium in the treatment of children with bipolar disorder in a manic state.”

More information

The U.S. National Institute of Mental Health has more about bipolar disorder.

Source: HealthDay

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