Compared with adults, youths were found to be more vulnerable to adverse effects of SGAs. All SGAs increased the risk of somnolence/sedation. Furthermore, substance-specific significant treatment-related changes compared with placebo were observed regarding weight gain, metabolic variables (including prolactin) and extrapyramidal-motor symptoms.
Second-generation antipsychotics (SGAs) represent an efficacious treatment for children and adolescents with bipolar disorder, whereby different tolerability profiles should be considered in making treatment decisions (Cohen et al., submitted for print).
Besides pharmacological treatment, educational and psychosocial strategies including psychotherapy, promotion of compliance with treatment, and education of patients and their families, are essential in the treatment of bipolar disorder in youth in order to improve the treatment outcome.
In case of no response to pharmacological treatment, electroconvulsive therapy (ECT) has proven to be a safe and effective treatment for both manic and depressive episodes in adolescents with severe illness (Cohen et al., 1997). Regarding the long-term outcome of adolescents who receive ECT, findings suggest that adolescents given ECT for bipolar disorder do not differ in subsequent school and social functioning from carefully matched controls
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European College of Neuropsychopharmacology