Thursday, October 29, 2015

Expert Makes Case to Use Lithium for Youth With Bipolar Disorder


Treating young patients with bipolar disorder can be challenging, but a growing body of evidence suggests lithium may be a good place to start, Vivian Kafentaris, M.D. (pictured left), said Tuesday at the annual meeting of the American Academy of Child and Adolescent Psychiatry in San Antonio.

“It is important that we recognize bipolar disorder early in youth and treat the disorder as early as possible,” said Kafentaris, the director of research in the Division of Child and Adolescent Psychiatry at Hofstra North Shore-LIJ School of Medicine. “A lot of people—both children and adults [with bipolar disorder]—have been on a multitude of medications but never on lithium.”

During her presentation, Kafentaris offered an overview of evidence-based strategies of off-label drugs for treating children and adolescents with bipolar disorder. In particular, she highlighted some data from the Collaborative Lithium Trials, which compared patients (aged 7 to 17 years) with bipolar I/manic or mixed episodes who were treated with lithium for up to 8 weeks with those treated with placebo.

The study, which was published this month in Pediatrics, found that those in the lithium group experienced a greater reduction in manic symptoms (as measured by changes in the Young Mania Rating Scale and Clinical Global Impression–Improvement scores) than those taking placebo. Additionally, the medication was generally well tolerated and was not associated with weight gain.

“The earlier lithium is instituted, the more likely it is to be effective,” Kafentaris told Psychiatric News. “If we wait and the severity of the illness progresses, then we run the risk of having to use multiple therapies to achieve mood stabilization.”

Although Kafentaris expressed optimism over the positive results of lithium treatment in children and adolescents with bipolar I disorder, she emphasized that more research is needed to determine the long-term effects of medication in youth.

For related information, see the Psychiatric News article “Lithium Is Regaining Favor Over Anticonvulsants.”

(Image: Vabren Watts/Psychiatric News)