Pediatric Drugs

, Volume 13, Issue 4, pp 225–243 | Cite as

Antidepressants and Psychostimulants in Pediatric Populations

Is there an Association with Mania?
Review Article

Abstract

This article reviews the literature that examines whether exposure to psychostimulants or antidepressants precipitates or exacerbates manic symptoms, or decreases the age at onset of mania in pediatric populations. A PubMed search using relevant key words identified studies targeting five distinct clinical groups: (i) youth without a diagnosis of bipolar disorder (BD) at the time of exposure to psychostimulants; (ii) youth with a diagnosis of BD at the time of exposure to psychostimulants; (iii) youth without a diagnosis of BD at the time of exposure to antidepressants; (iv) youth with a diagnosis of BD at the time of exposure to antidepressants; and (v) youth who develop BD after exposure to these medications.

In patients with attention-deficit hyperactivity disorder (ADHD), the risk for mania was found to be relatively low with the use of psychostimulants. For patients with BD and ADHD, effective mood stabilization is important prior to adding a stimulant. For children with depression and/or anxiety, the risk of antidepressant-induced mania (AIM) was generally low (<2%), but the risk of general ‘activation’ secondary to a selective serotonin reuptake inhibitor (SSRI) may be greater (2–10%). However, rates of AIM in specialty clinics appear to be much higher. SSRIs may be particularly problematic in specific populations, such as those with some symptoms of mania or a family history of BD, but the precise risk is unknown. There is no clear evidence that stimulants or SSRIs accelerate the natural course of BD development in overall samples, but in individual cases prescribers should proceed cautiously when using these agents in youth already at risk for developing BD, such as those with ADHD and mood dysregulation, a history of prior AIM, a history of psychosis, or a family history of BD.

References

  1. 1.
    Zito JM, Safer DJ, DosReis S, et al. Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med 2003 Jan; 157(1): 17–25PubMedCrossRefGoogle Scholar
  2. 2.
    Greenhill L, Beyer DH, Finkleson J, et al. Guidelines and algorithms for the use of methylphenidate in children with attention-deficit/hyperactivity disorder. J Atten Disord 2002; 6Suppl. 1: S89–100PubMedGoogle Scholar
  3. 3.
    Pliszka S, Dodson WW, Spencer TJ. Current treatments of attention-deficit/hyperactivity disorder. CNS Spectr 2000 May; 5 (5 Suppl. 3): S1–7PubMedGoogle Scholar
  4. 4.
    Pliszka S. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007; 46(7): 894–921PubMedCrossRefGoogle Scholar
  5. 5.
    Hughes C, Emslie G, Crismon M, et al. Texas children’s medication algorithm project: update from Texas consensus conference panel on medication treatment of childhood major depressive disorder. J Am Acad Child Adolesc Psychiatry 2007; 46(6): 667–86PubMedCrossRefGoogle Scholar
  6. 6.
    Boylan K, Romero S, Birmaher B. Psychopharmacologic treatment of pediatric major depressive disorder. Psychopharmacology 2007; 191(1): 27–38PubMedCrossRefGoogle Scholar
  7. 7.
    American Psychiatric Association. Diagnostic criteria from DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000Google Scholar
  8. 8.
    Carlson GA, Kelly KL. Manic symptoms in psychiatrically hospitalized children: what do they mean? J Affect Disord 1998 Nov; 51(2): 123–35PubMedCrossRefGoogle Scholar
  9. 9.
    Carlson GA, Loney J, Salisbury H, et al. Stimulant treatment in young boys with symptoms suggesting childhood mania: a report from a longitudinal study. J Child Adolesc Psychopharmacol 2000 Fall; 10(3): 175–84PubMedCrossRefGoogle Scholar
  10. 10.
    Galanter CA, Carlson GA, Jensen PS, et al. Response to methylphenidate in children with attention deficit hyperactivity disorder and manic symptoms in the multimodal treatment study of children with attention deficit hyperactivity disorder titration trial. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 123–36PubMedCrossRefGoogle Scholar
  11. 11.
    Arnold L, Abikoff H, Cantwell D, et al. NIMH collaborative multimodal treatment study of children with ADHD (MTA): design, methodology, and protocol evolution. J Atten Disord 1997; 2(3): 141–58CrossRefGoogle Scholar
  12. 12.
    Achenbach T. Child behavior checklist/4–18. Burlington (VT): University of Vermont, Department of Psychiatry, 1991Google Scholar
  13. 13.
    Shaffer D, Fisher P, Dulcan M, et al. The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA study. J Am Acad Child Adolesc Psychiatry 1996; 35(7): 865–77PubMedCrossRefGoogle Scholar
  14. 14.
    Tillman R, Geller B. Controlled study of switching from attention-deficit/hyperactivity disorder to a prepubertal and early adolescent bipolar I disorder phenotype during 6-year prospective follow-up: rate, risk, and predictors. Dev Psychopathol 2006 Fall; 18(4): 1037–53PubMedCrossRefGoogle Scholar
  15. 15.
    Shaffer D, Gould MS, Brasic J, et al. A children’s global assessment scale (CGAS). Arch Gen Psychiatry 1983 Nov; 40(11): 1228–31PubMedCrossRefGoogle Scholar
  16. 16.
    Scheffer R, Kowatch R, Carmody T, et al. Randomized, placebo-controlled trial of mixed amphetamine salts for symptoms of comorbid ADHD in pediatric bipolar disorder after mood stabilization with divalproex sodium. Am J Psychiatry 2005; 162(1): 58–64PubMedCrossRefGoogle Scholar
  17. 17.
    Guy W, Bonato R. CGI: Clinical global impressions. ECDEU assessment manual for psychopharmacology. Chevy Chase (MD): National Institute of Mental Health, 1976: 217–22Google Scholar
  18. 18.
    Young R, Biggs J, Ziegler V, et al. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978; 133(5): 429–35PubMedCrossRefGoogle Scholar
  19. 19.
    Findling RL, Short EJ, McNamara NK, et al. Methylphenidate in the treatment of children and adolescents with bipolar disorder and attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007; 46(11): 1445–53PubMedCrossRefGoogle Scholar
  20. 20.
    Poznanski E, Mokros H, Services WP. Children’s Depression Rating Scale. Rev. (CDRS-R). Los Angeles (CA): Western Psychological Services, 1996Google Scholar
  21. 21.
    Chang K, Nayar D, Howe M, et al. Atomoxetine as an adjunct therapy in the treatment of co-morbid attention-deficit/hyperactivity disorder in children and adolescents with bipolar I or II disorder. J Child Adolesc Psychopharmacol 2009; 19(5): 547–51PubMedCrossRefGoogle Scholar
  22. 22.
    DuPaul GJ, Power TJ, Anastopoulos AD, et al. ADHD rating scale-IV: checklists, norms, and clinical interpretation. New York: Guilford, 1998Google Scholar
  23. 23.
    Zeni CP, Tramontina S, Ketzer CR, et al. Methylphenidate combined with aripiprazole in children and adolescents with bipolar disorder and attention-deficit/hyperactivity disorder: a randomized crossover trial. J Child Adolesc Psychopharmacol 2009 Oct; 19(5): 553–61PubMedCrossRefGoogle Scholar
  24. 24.
    Faedda G. Treatment-emergent mania in pediatric bipolar disorder: a retrospective case review. J Affect Disord 2004; 82(1): 149–58PubMedCrossRefGoogle Scholar
  25. 25.
    Findling RL, Lingler J, Rowles BM, et al. A pilot pharmacotherapy trial for depressed youths at high genetic risk for bipolarity. J Child Adolesc Psychopharmacol 2008; 18(6): 615–21PubMedCrossRefGoogle Scholar
  26. 26.
    Baumer F, Howe M, Gallelli K, et al. A pilot study of antidepressant-induced mania in pediatric bipolar disorder: characteristics, risk factors, and the serotonin transporter gene. Biol Psychiatry 2006; 60(9): 1005–12PubMedCrossRefGoogle Scholar
  27. 27.
    Biederman J, Mick E, Spencer TJ, et al. Therapeutic dilemmas in the pharmacotherapy of bipolar depression in the young. J Child Adolesc Psychopharmacol 2000 Fall; 10(3): 185–92PubMedCrossRefGoogle Scholar
  28. 28.
    DelBello M, Soutullo C, Hendricks W, et al. Prior stimulant treatment in adolescents with bipolar disorder: association with age at onset. Bipolar Disord 2001; 3(2): 53–7PubMedCrossRefGoogle Scholar
  29. 29.
    Geller B, Williams M, Zimerman B, et al. Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS). St Louis (MO): Washington University, 1996Google Scholar
  30. 30.
    Martin A, Young C, Leckman JF, et al. Age effects on antidepressant-induced manic conversion. Arch Pediatr Adolesc Med 2004 Aug; 158(8): 773–80PubMedCrossRefGoogle Scholar
  31. 31.
    Chang K, Saxena K, Howe M, et al. Psychotropic medication exposure and age at onset of bipolar disorder in offspring of parents with bipolar disorder. J Child Adolesc Psychopharmacol 2010; 20(1): 25–32PubMedCrossRefGoogle Scholar
  32. 32.
    Koehler-Troy C, Strober M, Malenbaum R. Methylphenidate-induced mania in a prepubertal child. J Clin Psychiatry 1986 Nov; 47(11): 566–7PubMedGoogle Scholar
  33. 33.
    Schmidt K, Delaney MA, Jensen M, et al. Methylphenidate challenge in a manic boy. Biol Psychiatry 1986 Sep; 21(11): 1107–9PubMedCrossRefGoogle Scholar
  34. 34.
    Tversky A, Kahneman D. Availability: a heuristic for judging frequency and probability. Cogn Psychol 1973; 5: 207–32CrossRefGoogle Scholar
  35. 35.
    Bornstein BH, Emler AC. Rationality in medical decision making: a review of the literature on doctors’ decision-making biases. J Eval Clin Pract 2001 May; 7(2): 97–107PubMedCrossRefGoogle Scholar
  36. 36.
    Geller B, Tillman R, Craney JL, et al. Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype. Arch Gen Psychiatry 2004 May; 61(5): 459–67PubMedCrossRefGoogle Scholar
  37. 37.
    Singh MK, DelBello MP, Kowatch RA, et al. Co-occurrence of bipolar and attention-deficit hyperactivity disorders in children. Bipolar Disord 2006 Dec; 8(6): 710–20PubMedCrossRefGoogle Scholar
  38. 38.
    Thorndike RL. Personnel selection: test and measurement techniques. New York: John Wiley, 1949Google Scholar
  39. 39.
    Pearson K. Mathematical contributions to the theory of evolution. XI: On the influence of natural selection on the variability and correlation of organs. Philosophical transactions of the Royal Society of London Series A, containing papers of a mathematical or physical character. 1903; 200: 1–66CrossRefGoogle Scholar
  40. 40.
    Kowatch RA, Fristad M, Birmaher B, et al. Treatment guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 2005 Mar; 44(3): 213–35PubMedCrossRefGoogle Scholar
  41. 41.
    Soutullo CA, DelBello MP, Ochsner JE, et al. Severity of bipolarity in hospitalized manic adolescents with history of stimulant or antidepressant treatment. J Affect Disord 2002 Aug; 70(3): 323–7PubMedCrossRefGoogle Scholar
  42. 42.
    Joseph MF, Youngstrom EA, Soares JC. Antidepressant-coincident mania in children and adolescents treated with selective serotonin reuptake inhibitors. Future Neurol 2009; 4(1): 87–102PubMedCrossRefGoogle Scholar
  43. 43.
    Peet M. Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Br J Psychiatry 1994 Apr; 164(4): 549–50PubMedCrossRefGoogle Scholar
  44. 44.
    Altshuler L, Post R, Leverich G, et al. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry 1995; 152(8): 1130–8PubMedGoogle Scholar
  45. 45.
    McClellan J, Kowatch R, Findling RL. Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder [published erratum appears in J Am Acad Child Adolesc Psychiatry 2007; 46 (6): 786]. Work Group on Quality Issues. J Am Acad Child Adolesc Psychiatry 2007; 46(1): 107–25Google Scholar
  46. 46.
    Goldberg JF, Truman CJ. Antidepressant-induced mania: an overview of current controversies. Bipolar Disord 2003 Dec; 5(6): 407–20PubMedCrossRefGoogle Scholar
  47. 47.
    Hammad T. Results of the analysis of suicidality in pediatric trials of newer antidepressants. Psychopharmacologic Drugs Advisory Committee and the Pediatric Advisory Committee September 13–14, 2004: Division of Neuropharmacological Drug Products Center for Drug Evaluation and Research [slide 96; online]. Available from URL: http://www.fda.gov/ohrms/dockets/ac/04/slides/2004-4065S1_08_FDA-Hammad.ppt [Accessed 2011 May 26]
  48. 48.
    Cheung AH, Emslie GJ, Mayes TL. Review of the efficacy and safety of antidepressants in youth depression. J Child Psychol Psychiatry 2005; 46(7): 735–54PubMedCrossRefGoogle Scholar
  49. 49.
    Carlson GA, Mick E. Drug-induced disinhibition in psychiatrically hospitalized children. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 153–63PubMedCrossRefGoogle Scholar
  50. 50.
    Emslie G, Kratochvil C, Vitiello B, et al. Treatment for Adolescents with Depression Study (TADS). J Am Acad Child Adolesc Psychiatry 2006; 45(12): 1440–55PubMedCrossRefGoogle Scholar
  51. 51.
    Emslie G, Kratochvil C, Vitiello B, et al. Treatment for Adolescents with Depression Study (TADS): safety results. J Am Acad Child Adolesc Psychiatry 2006 Dec; 45(12): 1440–55PubMedCrossRefGoogle Scholar
  52. 52.
    Wilens TE, Biederman J, Kwon A, et al. A systematic chart review of the nature of psychiatric adverse events in children and adolescents treated with selective serotonin reuptake inhibitors. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 143–52PubMedCrossRefGoogle Scholar
  53. 53.
    Go FS, Malley EE, Birmaher B, et al. Manic behaviors associated with fluoxetine in three 12- to 18-year-olds with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 1998; 8(1): 73–80PubMedCrossRefGoogle Scholar
  54. 54.
    Masi G. Obsessive-compulsive bipolar comorbidity: focus on children and adolescents. J Affect Disord 2004; 78(3): 175–83PubMedCrossRefGoogle Scholar
  55. 55.
    Brent DA. The rewards of reducing risk. Arch Pediatr Adolesc Med 2004 Aug; 158(8): 824–5PubMedCrossRefGoogle Scholar
  56. 56.
    Emslie GJ, Rush AJ, Weinberg WA, et al. A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry 1997 Nov; 54(11): 1031–7PubMedCrossRefGoogle Scholar
  57. 57.
    Emslie GJ, Heiligenstein JH, Wagner KD, et al. Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial. J Am Acad Child Adolesc Psychiatry 2002 Oct; 41(10): 1205–15PubMedCrossRefGoogle Scholar
  58. 58.
    Geller B, Cooper TB, Zimerman B, et al. Lithium for prepubertal depressed children with family history predictors of future bipolarity: a double-blind, placebo-controlled study. J Affect Disord 1998 Nov; 51(2): 165–75PubMedCrossRefGoogle Scholar
  59. 59.
    DelBello MP, Chang K, Welge JA, et al. A double-blind, placebo-controlled pilot study of quetiapine for depressed adolescents with bipolar disorder. Bipolar Disord 2009 Aug; 11(5): 483–93PubMedCrossRefGoogle Scholar
  60. 60.
    Chang K, Dienes K, Blasey C, et al. Divalproex monotherapy in the treatment of bipolar offspring with mood and behavioral disorders and at least mild affective symptoms. J Clin Psychiatry 2003; 64(8): 936–42PubMedCrossRefGoogle Scholar
  61. 61.
    DelBello M, Adler C, Whitsel R, et al. A 12-week single-blind trial of quetiapine for the treatment of mood symptoms in adolescents at high risk for developing bipolar I disorder. J Clin Psychiatry 2007; 68(5): 781–8CrossRefGoogle Scholar
  62. 62.
    Goldstein BI, Levitt AJ. Prevalence and correlates of bipolar I disorder among adults with primary youth-onset anxiety disorders. J Affect Disord 2007; 103(1–3): 187–95PubMedCrossRefGoogle Scholar
  63. 63.
    Henin A, Biederman J, Mick E, et al. Childhood antecedent disorders to bipolar disorder in adults: a controlled study. J Affect Disord 2007; 99(1–3): 51–7PubMedCrossRefGoogle Scholar
  64. 64.
    Johnson JG, Cohen P, Brook JS. Associations between bipolar disorder and other psychiatric disorders during adolescence and early adulthood: a community-based longitudinal investigation. Am J Psychiatry 2000; 157(10): 1679–81PubMedCrossRefGoogle Scholar
  65. 65.
    Daray FM, Thommi SB, Ghaemi SN. The pharmacogenetics of antidepressant-induced mania: a systematic review and meta-analysis. Bipolar Disord 2010; 12(7): 702–6PubMedCrossRefGoogle Scholar
  66. 66.
    Biederman J, Mick E, Faraone SV, et al. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry 2000 Sep 15; 48(6): 458–66PubMedCrossRefGoogle Scholar
  67. 67.
    Geller B, Fox L, Clark K. Rate and predictors of prepubertal bipolarity during follow-up of 6-to 12-year-old depressed children. J Am Acad Child Adolesc Psychiatry 1994; 33(4): 461–8PubMedCrossRefGoogle Scholar
  68. 68.
    Henry C, Sorbara F, Lacoste J, et al. Antidepressant-induced mania in bipolar patients: identification of risk factors. J Clin Psychiatry 2001; 62(4): 249–55PubMedCrossRefGoogle Scholar
  69. 69.
    Truman C, Goldberg J, Nassir Ghaemi S, et al. Self-reported history of manic/hypomanic switch associated with antidepressant use: data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEPBD). J Clin Psychiatry 2007; 68(10): 1472–9PubMedCrossRefGoogle Scholar
  70. 70.
    Wehr T, Goodwin F. Rapid cycling in manic-depressives induced by tricyclic antidepressants. Arch Gen Psychiatry 1979; 36(5): 555–9PubMedCrossRefGoogle Scholar
  71. 71.
    Goldberg J, Nassir Ghaemi S. Benefits and limitations of antidepressants and traditional mood stabilizers for treatment of bipolar depression. Bipolar Disord 2005; 7: 3–12PubMedCrossRefGoogle Scholar
  72. 72.
    Sachs G, Printz D, Kahn D, et al. The expert consensus guideline series: medication treatment of bipolar disorder. Postgrad Med 2000; 1: 1–104Google Scholar
  73. 73.
    Salvadore G, Quiroz JA, Machado-Vieira R, et al. The neurobiology of the switch process in bipolar disorder. J Clin Psychiatry 2010; 71(11): 1488–501PubMedCrossRefGoogle Scholar
  74. 74.
    Faedda G, Baldessarini R, Glovinsky I, et al. Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disord 2004; 6(4): 305–13PubMedCrossRefGoogle Scholar
  75. 75.
    Fitzmaurice G. Regression to the mean. Nutrition 2000 Jan; 16(1): 80–1PubMedCrossRefGoogle Scholar
  76. 76.
    Geller B, Craney JL, Bolhofner K, et al. Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype. Am J Psychiatry 2002 Jun; 159(6): 927–33PubMedCrossRefGoogle Scholar
  77. 77.
    Chang K, Saxena K, Howe M. An open-label study of lamotrigine adjunct or monotherapy for the treatment of adolescents with bipolar depression. J Am Acad Child Adolesc Psychiatry 2006; 45(3): 298–304PubMedCrossRefGoogle Scholar
  78. 78.
    Patel N, DelBello M, Cecil K, et al. Lithium treatment effects on myoinositol in adolescents with bipolar depression. Biol Psychiatry 2006; 60(9): 998–1004PubMedCrossRefGoogle Scholar
  79. 79.
    Reichart C. Earlier onset of bipolar disorder in children by antidepressants or stimulants? An hypothesis. J Affect Disord 2004; 78(1): 81–4PubMedCrossRefGoogle Scholar
  80. 80.
    Chang K, Steiner H, Ketter T. Psychiatric phenomenology of child and adolescent bipolar offspring. J Am Acad Child Adolesc Psychiatry 2000; 39(4): 453–60PubMedCrossRefGoogle Scholar
  81. 81.
    Akiskal H. Developmental pathways to bipolarity: are juvenile-onset depressions pre-bipolar? J Am Acad Child Adolesc Psychiatry 1995; 34(6): 754–63PubMedCrossRefGoogle Scholar
  82. 82.
    Geller B, Zimerman B, Williams M, et al. Bipolar disorder at prospective follow-up of adults who had prepubertal major depressive disorder. Am J Psychiatry 2001; 158(1): 125–7PubMedCrossRefGoogle Scholar
  83. 83.
    DelBello MP, Carlson GA, Tohen M, et al. Rates and predictors of developing a manic or hypomanic episode 1 to 2 years following a first hospitalization for major depression with psychotic features. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 173–85PubMedCrossRefGoogle Scholar
  84. 84.
    Cicero D, El-Mallakh R, Holman J, et al. Antidepressant exposure in bipolar children. Psychiatry 2003; 66(4): 317–22PubMedCrossRefGoogle Scholar
  85. 85.
    Pagano M, Demeter C, Faber J, et al. Initiation of stimulant and antide-pressant medication and clinical presentation in juvenile bipolar I disorder. Bipolar Disord 2008; 10(2): 334–41PubMedCrossRefGoogle Scholar
  86. 86.
    Post R, Rubinow D, Ballenger J. Conditioning and sensitisation in the longitudinal course of affective illness. Br J Psychiatry 1986; 149(2): 191–201PubMedCrossRefGoogle Scholar
  87. 87.
    Chang K, Howe M, Gallelli K, et al. Prevention of pediatric bipolar disorder. Ann N Y Acad Sci 2006; 1094(1): 235–47PubMedCrossRefGoogle Scholar
  88. 88.
    Chang K, Steiner H, Ketter T. Studies of offspring of parents with bipolar disorder. Am J Med Genet C Semin Med Genet 2003 Nov 15; 123C(1): 26–35PubMedCrossRefGoogle Scholar
  89. 89.
    Carlson GA. The bottom line. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 115–8PubMedCrossRefGoogle Scholar
  90. 90.
    Hellander M. Medication-induced mania: ethical issues and the need for more research. J Child Adolesc Psychopharmacol 2003 Summer; 13(2): 199PubMedCrossRefGoogle Scholar
  91. 91.
    Michelson D, Faries D, Wernicke J, et al. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics 2001; 108(5): e83PubMedCrossRefGoogle Scholar
  92. 92.
    Cheung A, Dewa C, Levitt A. Clinical review of mania, hostility and suicide-related events in children and adolescents treated with antidepressants. Paediatr Child Health 2005; 10(8): 457–63PubMedGoogle Scholar
  93. 93.
    Safer DJ, Zito JM. Treatment-emergent adverse events from selective serotonin reuptake inhibitors by age group: children versus adolescents. J Child Adolesc Psychopharmacol 2006 Feb–Apr; 16(1–2): 159–69PubMedCrossRefGoogle Scholar
  94. 94.
    Strober M, Carlson G. Bipolar illness in adolescents with major depression: clinical, genetic, and psychopharmacologic predictors in a three-to four-year prospective follow-up investigation. Arch Gen Psychiatry 1982; 39(5): 549–55PubMedCrossRefGoogle Scholar
  95. 95.
    Rao U, Ryan N, Birmaher B, et al. Unipolar depression in adolescents: clinical outcome in adulthood. J Am Acad Child Adolesc Psychiatry 1995; 34(5): 566–78PubMedCrossRefGoogle Scholar
  96. 96.
    Kovacs M. Presentation and course of major depressive disorder during childhood and later years of the life span. J Am Acad Child Adolesc Psychiatry 1996; 35(6): 705–15PubMedCrossRefGoogle Scholar
  97. 97.
    Chang KD. Challenges in the diagnosis and treatment of pediatric bipolar depression. Dialogues Clin Neurosci 2009; 11(1): 73–80PubMedGoogle Scholar
  98. 98.
    Miklowitz DJ, Axelson DA, Birmaher B, et al. Family-Focused treatment for adolescents with bipolar disorder: results of a 2-year randomized trial. Arch Gen Psychiatry 2008 Sep 1; 65(9): 1053–61PubMedCrossRefGoogle Scholar
  99. 99.
    March JS. Multidimensional anxiety scale for children. North Tonawanda (NY): Multi-Health Systems, 1998Google Scholar
  100. 100.
    Shaffer D, Scott M, Wilcox H, et al. The Columbia Suicide Screen: validity and reliability of a screen for youth suicide and depression. J Am Acad Child Adolesc Psychiatry 2004; 43(1): 71–9PubMedCrossRefGoogle Scholar
  101. 101.
    Narayan V, Haddad PM. Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria. J Psychopharmacol 2011 Mar; 25(3): 306–13PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Michelle Goldsmith
    • 1
  • Manpreet Singh
    • 1
  • Kiki Chang
    • 1
  1. 1.Stanford Pediatric Bipolar Disorders ProgramStanford University School of Medicine, Department of PsychiatryStanfordUSA

Personalised recommendations