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Bipolar Network News Free Free Bipolar Network News Published since 1995 The latest news on bipolar disorder research from around the world bipolarnews.org Vol. 22, Issue 2, 2018 FDA Approves Lurasidone for Bipolar Depression in Children and Adolescents In March 2018, the US Food and In the study, lurasidone was delay between the emergence of symp- Drug Administration approved well-tolerated. Side effects included toms and the first treatment for bipolar the antipsychotic drug lurasidone nausea, sleepiness, minimal weight disorder is also a risk factor for more (Latuda) for the treatment of bipolar gain, and insomnia. Lurasidone did severe depression, more time depressed, depression in children and adoles- not seem to affect glucose, triglycer- and a poorer outcome in adulthood. cents aged 10–17 years. Lurasidone ides, cholesterol, or blood pressure. Parents of children aged 2-12 who was already approved for adults with have mood or behavioral problems are bipolar depression, as an add-on treat- Editor’s Note: This is the first drug encouraged to consider joining the Child ment to the mood stabilizers lithium to be approved for bipolar depression in Network at our website, bipolarnews.org and valproate, and for schizophre- this age range. This editor (Robert M. (click on the tab for the Child Network). nia in people aged 13 years and up. Post) has written extensively on the By participating in this research network, A 6-week clinical trial in 347 youth high incidence of childhood onset bipolar parents are able to make a weekly rating of compared lurasidone (in doses ranging disorder in the US, and especially in the the severity of their children’s symptoms of from 20 to 80 mg/day) to placebo offspring of parents with bipolar disorder. anxiety, depression, ADHD, oppositional and found that those who received It is important to be alert to the pos- behavior, and mania via the secure website. lurasidone showed significant im- sibilities of depression and bipolar disorder The ratings can then be shared with the provements in depression compared in children in the US (along with related child’s clinicians for easy visualization to those who received placebo. The illnesses such as anxiety, oppositional of the course of symptoms over time, average dose was below 40 mg/day. defiant disorder, and attention deficit which may help with treatment decisions. The research by Melissa P. DelBello hyperactivity disorder (ADHD)), as and colleagues was published in the early-onset illness tends to have a more Journal of the American Academy of severe long-term course than adult-onset Child and Adolescent Psychiatry in 2017. depression and bipolar disorder. A longer In This Issue: Pediatric Bipolar Disorder Diagnoses Bullying Affects Kids’ Much More Common in US than England Mental Health p. 3 A 2014 article by Anthony James and US were diagnosed with bipolar dis- colleagues in the Journal of the American order, only 22.1 adults per 100,000 in New Treatment for Academy of Child and Adolescent England received such a diagnosis, Fragile X p. 3 Psychiatry reported that hospitalizations making the diagnosis of bipolar disor- for pediatric bipolar disorder are 72.1 der in adults 7.2 times more common times higher in the US than in England. in the US. Diagnoses of childhood Playing Football Before The researchers determined that attention-deficit hyperactivity disor- Age 12 May Be there were 100.9 diagnoses of pediatric der (ADHD) were 13.0 times more Bad for the Brain p. 3 bipolar disorder per 100,000 people in common in the US than in England, the US, but only 1.4 cases per 100,000 while cases of childhood depression people in England. The discrepancy were 4.2 times more common in the US. Treating a in diagnoses for adult bipolar disorder James and colleagues hypothesized Multi-Symptomatic and for other childhood psychiatry several potential reasons for the dra- Child p. 4-7 illnesses were smaller but still notable: matic difference in diagnosis rates at While 158.2 adults per 100,000 in the Continued on Page 2 An Independent Publication of Bipolar Disorder Investigators BNN V. 22, Iss. 2, 2018 bipolarnews.org More Childhood-Onset Illness in the US Than in Other Countries Continued from Page 1 However, children in the US of adult males aged 55–64 in the US hospital discharge of bipolar disorder in may simply be more likely to have versus England. US men had a higher children in the US versus England. The a variety of childhood psychiatric incidence of virtually every common lower hospitalization rates for pediatric disorders than those from England. medical condition, including diabetes, bipolar disorder in England may reflect hypertension, heart disease, heart attack, the better availability of community Editor’s Note: A 2011 meta-analysis of stroke, lung disease, and cancer, and these or outpatient treatment options there. epidemiological studies by researcher Anna results held up even when the research- Diagnostic practices may also differ. R. Van Meter in the Journal of Clinical ers controlled for socio-economic status James and colleagues suggested that in Psychiatry supports the view that bipolar and access to health care. Banks and col- the US, pediatric diagnoses of bipolar disorder not otherwise specified (BP-NOS), leagues concluded that American men are disorder are often used to describe which is often the earliest manifestation in much worse health than British men. children and adolescents with irritabil- of bipolar disorder, is about twice as In a 2018 editorial in the journal ity and frequent mood shifts, whereas common in the US than in other countries. BMJ, Steven H. Woolf and Laudan English diagnostic practices rely more Even if there are some diagnostic dif- Aron further highlight that after on episodic bouts of euphoria to di- ferences that contribute to the immense losing ground for decades, US life agnose bipolar disorder in children. 72.1 fold higher rates of hospitalization for expectancy has now fallen below the childhood bipolar in the US compared to average for other developed countries. Britain, one cannot overlook the findings Bipolar Network News that these children are requiring hospital- It looks like in addition to Americans bipolarnews.org ization for something resembling bipolar suffering poorer general health than people Editor-in-Chief: Robert M. Post, MD disorder and are in need of treatment. in other developed countries, children in Managing Editor: Moira McCauley In England the researchers found America may also be psychiatrically much TheBNN is published 4–6 times a year by investigators no diagnoses of bipolar disorder in pre- sicker. The high rates of bipolar disorder working with patients with bipolar disorder to better adolescent children, whereas in the US, in US children are catastrophic, not to understand the long-term course of illness. The newsletter is available free of charge to all who request diagnoses in children under age 6 exceeded mention the toll of conditions that tend it. the rates of pediatric bipolar disorder in to accompany bipolar disorder and other Although the editors of the BNN have made every 19-year-olds in England. In a 2017 review mood, anxiety, and behavioral disorders. effort to report accurate information, much of the article in the journal Neuroscience & Yet there does not appear to be any recogni- work detailed here is in abstract or pre-publication Biobehavioral Reviews, this editor tion of the magnitude of the problem or form, and therefore cannot be taken as verified data. The BNN can thus assume no liability for errors of Robert M. Post and colleagues reviewed public sector attempts to ameliorate it. fact or omission, or lack of balance. Patients should research on incidence of childhood onset Woolf and Aron end their BMJ editorial consult with their physicians, and physicians with the published literature, before making any treatment bipolar disorder and found higher rates on a pessimistic note: “Ironically, leaders decisions based on information given in this issue or in of the illness in the US than in Canada, are outspoken about ending the opioid BNN any issue of the . Argentina, and several European coun- epidemic and bemoan spiraling and unsus- Dr. Post has consulted on behalf of drug companies tries. Genetic and environmental factors tainable healthcare costs. Solutions to both including Abbott, Astra Zeneca, Bristol-Myers Squibb, Glaxo-SmithKline, Jansen, and Pfizer. contributed to this vulnerability in US problems—which involve investment to patients. Compared to Europeans in the support struggling families and communi- The opinions expressed in the BNN are solely those of Dr. Post, and do not represent the views of any Netherlands and Germany, those with ties and thereby improve public health—are scientific entity or foundation. bipolar disorder in the US have more often rejected, usually by leaders with Send any comments or suggestions to: family history of psychiatric illness and competing self-interests or ideological ob- [email protected] face more psychosocial stress in childhood. jections. The consequences of these choices BNN are dire: not only more deaths and illness 5415 W. Cedar Lane Suite 201B Several studies have also found that but also escalating healthcare costs, a sicker Bethesda, MD 20814 general medical health in adult males workforce, and a less competitive economy. To subscribe or unsubscribe, see our website is worse in the US than in other devel- Future generations may pay the great- or email us at: oped countries, as is life expectancy. est price.” This editor (Robert M. Post) [email protected]. A 2006 study by James Banks and would further emphasize that most adult Note that we do not accept requests to colleagues in JAMA, the Journal of psychiatric disorders begin in childhood, subscribe friends or family members.
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