Lithium Versus Divalproex for Treating Pediatric Bipolar Disorder

Bipolar Disorder Clinical Trial

— PBC  

Official title:

Pediatric Bipolar Collaborative Mood Stabilizer Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00221429
• Other study ID #: R01MH063632
• Secondary ID: R01MH063632DSIR
• Status: Completed
• Phase: Phase 3
• Start date: March 2001
• Est. completion date: February 2015

Study information

• Verified date: February 2024
• Source: Children's Hospital Medical Center, Cincinnati
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study compared the efficacy of lithium, divalproex, and placebo in treating the acute phase of symptomatic bipolar I disorder, mixed or manic episode, in children and adolescents.

Description:

Primary Aim:

To compare the efficacy of lithium (LI), divalproex (DVP), and placebo (PBO) in the acute phase treatment of symptomatic bipolar I disorder, mixed or manic episode, in children and adolescents. Our hypothesis is that differential efficacy will be observed with the following predicted order of response: divalproex (DVP) = lithium (LI) > placebo (PBO).

Secondary Aims:

1. To collect systematic safety data on the incidence of weight gain and the development of insulin resistance and hyperandrogenism in bipolar adolescent females treated with LI, DVP, or LI + DVP.

2. To collect data on possible predictors of acute treatment response to the two active treatments.

3. To provide descriptive information on the stability of acute phase response to monotherapy with either LI or DVP over 6 months of continuation phase treatment.

4. To develop safety and efficacy data about the use of stimulant medications in these subject while treated with a mood stabilizer.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 153
• Est. completion date: February 2015
• Est. primary completion date: August 2006
• Accepts healthy volunteers: No
• Gender: All
• Age group: 7 Years to 18 Years

Eligibility

Inclusion Criteria:

1. 7.0 - 17 years of age

2. Bipolar I Disorder, mixed or manic episode, psychotic or non-psychotic, according to DSM IV criteria

3. Score of > 14 on the Y-MRS

4. Normal intelligence

5. Ability and willingness to provide assent and informed, written consent from at least one parent or legal guardian

6. No current general medical illnesses requiring medication

Exclusion Criteria:

• 1. A current or lifetime DSM-IV diagnosis of schizophrenia, autistic disorder, schizoaffective disorder, pervasive developmental disorder, or obsessive compulsive disorder 2. IQ < 70 3. Patients with serious suicide risk 4. Concurrent cognitive-behavior therapy that is specifically focused on the child or adolescent's bipolar symptoms within 6 weeks of enrolling in this trial.

5. Any use of psychotropic agents within the preceding 2 weeks, including neuroleptics, monoamine oxidase inhibitors, stimulants, antidepressants, or depot neuroleptics or fluoxetine in the past month 6. Current or history in past 3 months of a DSM-IV diagnosis of Substance Abuse/Dependence or use of illicit drugs or alcohol in the past 3 weeks. Patients who have a positive drug screen at intake, who would otherwise be eligible for the study, will be given the opportunity to repeat the drug screen 3 weeks later. They will be excluded if the second drug screen is positive.

7. Pregnancy or sexually active females not using a reliable form of contraception 8. Previous adequate trial of either LI or DVP defined as; 3 weeks of DVP at serum levels between 75-125 OR dosage of at least 20 mg/kg; Lithium for at least 4 weeks at serum levels of .8 - 1.2 or dosage of at least 30 mg/kg.

9. Allergies to LI, DVP or chlorpromazine. 10. Bipolar subjects who are currently stable on mood stabilizers or atypical neuroleptics.

11. Bipolar subjects with Bipolar I disorder and ADHD who are stable on stimulants with or without concurrent mood stabilizers.

12. Inpatient hospitalization within 6 months prior to screening. Partial hospitalization is acceptable.

Related Conditions & MeSH terms

• Bipolar Disorder

Intervention

Drug:
• Lithium
lithium
• sodium divalproex
Depakote

Other:
• Placebo
Placebo

Locations

Country	Name	City	State
United States	University of Cincinnati Medical Center/Medical Sciences Building	Cincinnati	Ohio

Sponsors (2)

Lead Sponsor	Collaborator
Children's Hospital Medical Center, Cincinnati	National Institute of Mental Health (NIMH)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Young Mania Rating Scale (YMRS) & Clinical Global Impressions I (CGI-I)		8 weeks
Secondary	CDRS & MRS		8 weeks