Bipolar disorder causes unusual shifts in mood, energy, activity levels and the ability to carry out basic tasks. Although some people have their first symptoms during childhood, the disorder usually develops in the late teens or early adult years.
During the study, the most common negative reaction that led to antidepressant discontinuation was increased irritability, which occurred in seven children.
Five of the participants experienced increased aggression, while two had increased impulsivity, two developed psychosis, one developed suicidal ideation, one insomnia, and one had increased hyperactivity. Two patients were admitted to hospital for aggression, as was the patient who developed suicidal ideation.
More than half of the children in the study had to discontinue treatment, said lead researcher Jeffrey Strawn, M.D., of the University of Cincinnati College of Medicine, Ohio, and colleagues in the journal Bipolar Disorders.
Researchers found that the probability that a child would need to discontinue taking an antidepressant is especially high among younger kids—the chances rise 1.8-fold for each 1-year decrease in age.
In fact, the chance for a bad reaction to an antidepressant is 97 percent in a 9-year old, but just 4 percent for a 20-year old, although they warn that “the probability at any particular age is necessarily rather imprecise given the small sample size.”
The 21 study participants who were already taking antidepressant drugs were pulled from a group of 118 young people, between the ages of 9 and 20 years, who had at least one parent with bipolar I disorder.
The children had started antidepressant treatment for a variety of reasons — most commonly because of a depressive or anxiety disorder — but also for a disruptive behavior disorder or attention-deficit hyperactivity disorder. Twelve were diagnosed with more than one disorder.
The researchers note that “given the poor tolerability of antidepressants in [high-risk] youth presenting with anxiety and depressive disorders, psychotherapeutic interventions that are currently recommended for these conditions might be tried prior to antidepressant medications.”
Source: Bipolar Disorders