In 2008, the FDA approved the atypical antipsychotic aripiprazole (Abilify) for the acute treatment of manic and mixed episodes of bipolar I disorder in children ages 10 - 17. Aripiprazole is the second atypical antipsychotic drug to be approved for short-treatment of older children with bipolar I disorder.
In 2008, the FDA warned that antiseizure drugs can increase the risk for suicidal thoughts and behavior as soon as 1 week after starting drug therapy. The risk for suicidality can continue for at least 6 months. All patients who take these drugs should be monitored for worsening depression or unusual changes in behavior.
Antiseizure drugs are sometimes used as a treatment for bipolar disorder. These drugs include valproate (Depakote, Stavzor),lamotrigine (Lamictal), carbamazepine (Epitol,Tegretol), gabapentin (Neurontin), zonisamide (Zonegran) and topiramate (Topamax).
Treatment of Bipolar Disorder During Pregnancy
In 2008, the American College of Obstetricians and Gynecologists (ACOG) released guidelines for the use of psychiatric medications during pregnancy. For treatment of pregnant patients with bipolar disorder, ACOG recommends:
ACOG Committee on Practice Bulletins--Obstetrics. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2008 Apr;111(4):1001-20.
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Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007 Apr 26;356(17):1711-22. Epub 2007 Mar 28.
Scherk H, Pajonk FG, Leucht S. Second-generation antipsychotic agents in the treatment of acute mania: a systematic review and meta-analysis of randomized controlled trials. Arch Gen Psychiatry. 2007 Apr;64(4):442-55.
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