Lithium isn't much help for teens with mania
July 27, 2004

NEW YORK (Reuters Health) - Mania, often a component of bipolar disorder, can be treated with lithium, but it doesn't seem to be very effective for adolescents with the condition.

That's according to Dr. Vivian Kafantaris and colleagues from the Zucker Hillside Hospital in Glen Oaks, New York, reporting the results of a study in the Journal of the American Academy of Child and Adolescent Psychiatry.

Adolescents in the study who were suffering from acute mania were given treatment with lithium for at least 4 weeks to stabilize their mental state. Those who responded were randomly assigned to continue on lithium or were given an inactive placebo drug for a further 2-week phase.

A total of 100 patients made up the original group. Among those with psychotic features or aggression, only 20 percent to responded to lithium, significantly fewer than the 60 percent of those without psychosis or aggression.

A total of 40 subjects responded to open lithium treatment and went into the second phase of the study. Over half the group experienced a significant worsening of symptoms. The flare-up rate was only slightly lower in subjects who continued on lithium (53 percent) than in those who received a placebo (62 percent).

"Our results highlight the need to investigate more precisely the role that mood stabilizers play in attaining rapid stabilization of this impairing condition," Kafantaris and colleagues conclude.

"Future studies should identify who can be safely and effectively stabilized on mood stabilizers alone, as well as the type and duration of adjunctive treatment necessary for longer term response."

Source: Journal of the American Academy of Child and Adolescent Psychiatry, August 2004.