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ABSTRACT: ObjectiveTo develop effect sizes for 3 mood stabilizers-lithium, divalproex sodium, and carbamazepine-for the acute-phase treatment of bipolar I or II disorder, mixed or manic episode, in children and adolescents aged 8 to 18 years.MethodForty-two outpatients with a mean age of 11.4 years (20 with bipolar I disorder and 22 with bipolar II disorder) were randomly assigned to 6 weeks of open treatment with either lithium, divalproex sodium, or carbamazepine. The primary efficacy measures were the weekly Clinical Global Impression Improvement scores and the Young Mania Rating Scale (Y-MRS).ResultsUsing a ≥50% change from baseline to exit in the Y-MRS scores to define response, the effect size was 1.63 for divalproex sodium, 1.06 for lithium, and 1.00 for carbamazepine. Using this same response measure with the intent-to-treat sample, the response rates were as follows: sodium divalproex, 53%; lithium, 38%; and carbamazepine, 38% (χ22 = 0.85, p = .60). All 3 mood stabilizers were well tolerated, and no serious adverse effects were seen.ConclusionsDivalproex sodium, lithium, and carbamazepine all showed a large effect size in the open treatment of children and adolescents with bipolar I or II disorder in a mixed or manic episode.
Journal of the American Academy of Child & Adolescent Psychiatry 07/2000; · 6.97 Impact Factor