SGAs trong điều trị bệnh nhân ngoại trú của trạng thái hưng cảm hoặc hỗn hợp trong thanh niên, một kiểm soát thử nghiệm của quetiapine kết hợp với divalproex (DVP) cho các cấp điều trị của các quốc gia hưng cảm và hỗn hợp trong thanh thiếu niên bị rối loạn lưỡng cực | Atypical Antipsychotics 73 trolled monotherapy trials Biederman et al. 2006 DelBello Kowatch et al. 2006 of SGAs in outpatient treatment of manic or mixed states in youths one small controlled trial of quetiapine in combination with divalproex DVP for the acute treatment of manic and mixed states in adolescents with bipolar disorder DelBello et al. 2002 and three open-label combination-therapy trials with DVP or lithium and quetiapine or haloperidol Kafantaris Dicker Coletti Kane 2001 Kafantaris Coletti Dicker Padula Kane 2001 Marchand et al. 2004 . Prospective studies that assess the treatment of psychotic and depressive symptoms in youths with bipolar disorder as well as studies to evaluate maintenance therapy in this population are limited in number. There have been two prospective studies utilizing the typical antipsychotics combined with lithium for the acute treatment of psychotic and nonpsychotic mania in adolescents with bipolar disorder Kafantaris Coletti et al. 2001 Kafantaris Dicker et al. 2001 . There have been no published studies of antipsychotic treatment for bipolar depression in youths. However promising data were recently presented from a doubleblind placebo-controlled trial of quetiapine monotherapy in adolescents with bipolar disorder and depressive symptoms Barzman et al. 2005 Kafantaris Coletti et al. 2001 . Evidence for the use of antipsychotics as monotherapy in the maintenance treatment of early-onset BPD is so far limited to one 9-month study that used risperidone as part of a treatment algorithm Kafantaris Coletti et al. 2001 Pavuluri Henry Carbray et al. 2004 . The paucity of experimental data for the treatment of bipolar disorder in children and adolescents has led to the publishing of treatment guidelines based on expert consensus Kafantaris Coletti et al. 2001 Kowatch et al. 2005 . Treatment response is most often assessed by treatment-associated reduction in symptom severity as measured by the Young Mania Rating Scale YMRS Gracious .
