A Randomized Controlled Trial of Risperidone, Lithium, or Divalproex Sodium for Initial Treatment of Bipolar I Disorder, Manic or Mixed Phase, in Children and Adolescents

Abstract

Childhood mania is a seriously impairing, often psychotic illness with a chronic natural history that continues into adulthood and has increased risks of substance use disorders and suicidality.^1-6 These clinical phenomena warrant rigorous intervention and may be, in part, responsible for the recent dramatic increase in use of antipsychotic medications for child psychiatry outpatients.⁷ In spite of marked metabolic effects of antipsychotic medications in children⁸ and the consequent need for comparative pharmacological research, there is a dearth of such studies.⁹