ReviewPaediatric drugs2011
Antidepressants and psychostimulants in pediatric populations: is there an association with mania?
Review in Paediatric drugs, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Childhood factors associated with increased risk for mood episode recurrences in bipolar disorder-A systematic review.Bipolar disorders · 2019Pooled it
- The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis.Journal of the American Academy of Child and Adolescent Psychiatry · 2018Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder.Bipolar disorders · 2018Guideline
- A Pharmacologic Algorithm for Youth Who Are at High Risk for Bipolar Disorder.Journal of child and adolescent psychopharmacology · 2017Trial
- Antidepressant treatment and risk of subsequent bipolar disorder in adolescents with unipolar depression.BMJ mental health · 2025Article
- Predicting five-year comorbid bipolar disorder after attention-deficit/hyperactivity disorder diagnosis: a population-based machine learning approach.Child and adolescent psychiatry and mental health · 2025Article
- A systematic review of selective serotonin reuptake inhibitor (SSRI)-induced activation and manic/hypomanic switch in children and adolescents.Scandinavian journal of child and adolescent psychiatry and psychology · 2025Review
- Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Pharmacogenetic Factors Influence Escitalopram Pharmacokinetics and Adverse Events in Youth with a Family History of Bipolar Disorder: A Preliminary Study.Journal of child and adolescent psychopharmacology · 2024Article
- Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2022Article
- A Double-Blind Randomized Trial to Investigate Mechanisms of Antidepressant-Related Dysfunctional Arousal in Depressed or Anxious Youth at Familial Risk for Bipolar Disorder.Journal of personalized medicine · 2022Article
- The Challenges of Children with Bipolar Disorder.Medicina (Kaunas, Lithuania) · 2021Review
- Toward prevention of bipolar disorder in at-risk children: Potential strategies ahead of the data.Journal of affective disorders · 2020Review
- Antidepressants for Pediatric Patients.Current psychiatry · 2019Article
- Clinical Conundrum: How do you treat youth with depression and a family history of bipolar disorder?Bipolar disorders · 2019Article
- Parsing cyclothymic disorder and other specified bipolar spectrum disorders in youth.Journal of affective disorders · 2018Article
- Antidepressant-Induced Activation in Children and Adolescents: Risk, Recognition and Management.Current problems in pediatric and adolescent health care · 2018Review
- Treatment of psychiatric symptoms among offspring of parents with bipolar disorder.Current treatment options in psychiatry · 2017Article
- The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research.Bipolar disorders · 2017Review
- Longitudinal course and characteristics of cyclothymic disorder in youth.Journal of affective disorders · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
This article reviews the literature that examines whether exposure to psychostimulants or antidepressants precipitates or exacerbates manic symptoms, or decreases the age at onset of mania in pediatric populations. A PubMed search using relevant key words identified studies targeting five distinct clinical groups: (i) youth without a diagnosis of bipolar disorder (BD) at the time of exposure to psychostimulants; (ii) youth with a diagnosis of BD at the time of exposure to psychostimulants; (iii) youth without a diagnosis of BD at the time of exposure to antidepressants; (iv) youth with a diagnosis of BD at the time of exposure to antidepressants; and (v) youth who develop BD after exposure to these medications. In patients with attention-deficit hyperactivity disorder (ADHD), the risk for mania was found to be relatively low with the use of psychostimulants. For patients with BD and ADHD, effective mood stabilization is important prior to adding a stimulant. For children with depression and/or anxiety, the risk of antidepressant-induced mania (AIM) was generally low (<2%), but the risk of general 'activation' secondary to a selective serotonin reuptake inhibitor (SSRI) may be greater (2-10%). However, rates of AIM in specialty clinics appear to be much higher. SSRIs may be particularly problematic in specific populations, such as those with some symptoms of mania or a family history of BD, but the precise risk is unknown. There is no clear evidence that stimulants or SSRIs accelerate the natural course of BD development in overall samples, but in individual cases prescribers should proceed cautiously when using these agents in youth already at risk for developing BD, such as those with ADHD and mood dysregulation, a history of prior AIM, a history of psychosis, or a family history of BD.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.