The effectiveness and tolerability of aripiprazole for pediatric bipolar disorders: A retrospective chart review

Objective: The aim of this retrospective chart review was to evaluate the effectiveness and tolerability of aripiprazole for the treatment of children and adolescents with bipolar disorders. Methods: The medical charts of all children and adolescents with a DSM-IV diagnosis of bipolar disorder, type I, type II, not otherwise specified (NOS), or schizoaffective disorder, bipolar type, and who were treated with aripiprazole were reviewed by two child and adolescent psychiatrists who independently confirmed their DSM-IV diagnoses, severity, and the improvement of illness using the Clinical Global Impression (CGI) Severity and Improvement scores for bipolar disorder (CGI-BP) and the Clinical Global Assessment Scale (CGAS). Results: Thirty patients who were treated with aripiprazole were identified (mean starting dose = 9 +/- 4 mg/day, mean final dose = 10 +/- 3 mg/day). The overall response rate, defined by a CGI-Improvement score of less than or equal to 2 at endpoint, was 67%. There was a statistically significant improvement in CGAS scores (48 +/- 11 to 65 +/- 11, signed rank = 191, p < 0.0001) and CGI-S scores (4.2 +/- 0.8 to 2.8 +/- 1.0, signed rank = -172, p < 0.0001, effect size = 1.90) from baseline to endpoint. No serious adverse events were identified. Common side effects were sedation (n = 10, 33%), akathisia (n = 7, 23%), and gastrointestinal disturbances (n = 2, 7%). Baseline and endpoint weights were available for 14 (47%) of the patients. Change in weight ranged from +5 to -21 kg and 12 (86%) of 14 patients lost weight (mean weight loss was 3 6 kg). Conclusions: This retrospective chart review suggests that aripiprazole may be effective and well tolerated for children and adolescents with bipolar disorders. Controlled studies of aripiprazole for the treatment of pediatric bipolar disorder are necessary.