{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:29:11Z","timestamp":1792081751442,"version":"4.4.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study examined the long-term effectiveness of lithium for the treatment of pediatric bipolar disorder within the context of combination mood stabilizer therapy for refractory mania and pharmacological treatment of comorbid psychiatric conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Outpatients, ages 7\u201317 years, meeting American Psychiatric Association,\n                      <jats:italic toggle=\"yes\">Diagnostic and Statistical Manual of Mental Disorders,<\/jats:italic>\n                      4th ed. (DSM-IV) diagnostic criteria for bipolar disorder I (BP-I) (manic or mixed) who demonstrated at least a partial response to 8 weeks of open-label treatment with lithium (Phase I) were eligible to receive open-label lithium for an additional 16 weeks (Phase II). Up to two adjunctive medications could be prescribed to patients experiencing residual symptoms of mania or comorbid psychiatric conditions, following a standardized algorithm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-one patients received continued open-label long-term treatment with lithium for a mean of 14.9 (3.0) weeks during Phase II. The mean weight-adjusted total daily dose at end of Phase II was 27.8 (6.7) mg\/kg\/day, with an average lithium concentration of 1.0 (0.3) mEq\/L. Twenty-five of the 41 patients (60.9%) were prescribed adjunctive psychotropic medications for residual symptoms. The most frequent indications for adjunctive medications were refractory mania (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =13; 31.7%) and attention-deficit\/hyperactivity disorder (ADHD) (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =15; 36.6%). At the end of this phase 28 (68.3%) patients met\n                      <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                      criteria for response (\u226550% reduction from Phase I baseline in Young Mania Rating Scale [YMRS] summary score and a Clinical Global Impressions-Improvement [CGI-I] score of 1 or 2), with 22 (53.7%) considered to be in remission (YMRS summary score\u226412 and CGI-Severity score of 1 or 2). These data suggest that patients who initially responded to lithium maintained mood stabilization during continuation treatment, but partial responders did not experience further improvement during Phase II, despite the opportunity to receive adjunctive medications. The most commonly reported (\u226520%) adverse events associated with lithium treatment were vomiting, headache, abdominal pain, and tremor.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Lithium may be a safe and effective longer-term treatment for patients with pediatric bipolar disorder who respond to acute treatment with lithium. Partial responders to acute lithium did not appear to experience substantial symptom improvement during the continuation phase, despite the possibility that adjunctive medications could be prescribed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2012.0063","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T16:42:14Z","timestamp":1363711334000},"page":"80-90","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":64,"title":["Post-Acute Effectiveness of Lithium in Pediatric Bipolar I Disorder"],"prefix":"10.1177","volume":"23","author":[{"given":"Robert L","family":"Findling","sequence":"first","affiliation":[{"name":"Johns Hopkins University and the Kennedy Krieger Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Kafantaris","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital and Feinstein Institute for Medical Research of the North Shore\u2014Long Island Jewish Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mani","family":"Pavuluri","sequence":"additional","affiliation":[{"name":"University of Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora K","family":"McNamara","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center\/ Case Western Reserve University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean A","family":"Frazier","sequence":"additional","affiliation":[{"name":"University of Massachusetts Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linmarie","family":"Sikich","sequence":"additional","affiliation":[{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kowatch","sequence":"additional","affiliation":[{"name":"Center for Innovation for Pediatric Practice"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brieana M","family":"Rowles","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center\/ Case Western Reserve University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci E","family":"Clemons","sequence":"additional","affiliation":[{"name":"EMMES Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perdita","family":"Taylor-Zapata","sequence":"additional","affiliation":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,3,1]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/YIC.0b013e3282f94ad0"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.1635"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.5.481"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.4.392"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/106342669700500404"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0906"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200210000-00011"},{"key":"e_1_3_3_9_1","doi-asserted-by":"crossref","unstructured":"DuPaul GJ Power TJ Anastopoulos AD Reid R. ADHD Rating Scale \u2013 IV: Checklists norms and clinical interpretation. New York: The Guilford Press 1998.","DOI":"10.1037\/t00680-000"},{"key":"e_1_3_3_10_1","article-title":"The Collaborative Lithium Trials (CoLT): specific aims, methods, implementation","volume":"21","author":"Findling RL","year":"2008","unstructured":"Findling RL, , Frazier JA, , Kafantaris V, , Kowatch R, , McClellan J, , Pavuluri M, , Sikich L, , Hlastala S, , Hooper SR, , Demeter CA, , Bedoya D, , Brownstein B, , Taylor\u2013Zapata P. The Collaborative Lithium Trials (CoLT): specific aims, methods, implementation. Child Adolesc Psychiatry Ment Health, 21. 2008.","journal-title":"Child Adolesc Psychiatry Ment Health"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-5618.2001.30405.x"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2010.0084"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CHI.0000046893.27264.53"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09m05164yel"},{"key":"e_1_3_3_15_1","first-page":"43","volume-title":"Treatment of Bipolar Disorder in Children and Adolescents","author":"Findling RL","year":"2008","unstructured":"Findling RL, , Pavuluri MN. Lithium. Treatment of Bipolar Disorder in Children and Adolescents. Geller B, , DelBello M. New York: Guilford Press, 2008; 43\u201368."},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31814b8d3b"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.1508"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/10445460050167269"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200402000-00018"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000142668.29191.13"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00750.x"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/104454601750143500"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.59.6.530"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200112000-00016"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199707000-00021"},{"key":"e_1_3_3_26_1","first-page":"501","volume-title":"Clinical Evaluation of Psychotropic Drugs: Principles and Guidelines","author":"Klein RG","year":"1994","unstructured":"Klein RG, , Abikoff H, , Barkley RA, , Campbell M, , Leckman JF, , Ryan ND, , Solanto MV, , Whalen CK. Clinical trials in children and adolescents. Clinical Evaluation of Psychotropic Drugs: Principles and Guidelines. Prien RF, , Robinson DS. New York: Raven Press, Ltd., 1994; 501\u2013546."},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v65n0618"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1987.tb10566.x"},{"key":"e_1_3_3_29_1","first-page":"11","article-title":"Antecedents of severe affective (mood) disorders: patients examined as children or adolescents and as adults","volume":"56","author":"Manzano J","year":"1993","unstructured":"Manzano J, , Salvador A. Antecedents of severe affective (mood) disorders: patients examined as children or adolescents and as adults. Acta Paedopsychiatr, 56:11\u201318. 1993.","journal-title":"Acta Paedopsychiatr"},{"key":"e_1_3_3_30_1","first-page":"102","article-title":"The impact of long-term lithium treatment on renal function in an outpatient population","volume":"77","author":"McCann SM","year":"2008","unstructured":"McCann SM, , Daly J, , Kelly CB. The impact of long-term lithium treatment on renal function in an outpatient population. Ulster Med J, 77:102\u2013105. 2008.","journal-title":"Ulster Med J"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/j.1440-1614.2005.01649.x"},{"key":"e_1_3_3_32_1","first-page":"839","article-title":"Clinical Global Impressions Scale","volume":"21","author":"National Institute of Mental Health:","year":"1985","unstructured":"National Institute of Mental Health:. Clinical Global Impressions Scale. Psychopharmacol Bull, 21:839\u2013843. 1985a.","journal-title":"Psychopharmacol Bull"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2006.16.336"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.05.017"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.01.022"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.2.217"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-198403000-00011"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200209000-00006"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.1.58"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1983.01790100074010"},{"key":"e_1_3_3_41_1","first-page":"1","article-title":"A rating scale for extrapyramidal side effects","volume":"212","author":"Simpson GM","year":"1970","unstructured":"Simpson GM, , Angus JWS. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl, 212:1\u201319. 1970.","journal-title":"Acta Psychiatr Scand Suppl"},{"key":"e_1_3_3_42_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.132.2.164"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200312000-00016"},{"key":"e_1_3_3_44_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.06111932"},{"key":"e_1_3_3_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2010.04.018"},{"key":"e_1_3_3_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e31819c55ec"},{"key":"e_1_3_3_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370905400208"},{"key":"e_1_3_3_48_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.133.5.429"},{"key":"e_1_3_3_49_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0517"},{"key":"e_1_3_3_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2005.05.090"}],"container-title":["Journal of Child and Adolescent Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/cap.2012.0063","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cap.2012.0063","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cap.2012.0063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:55:32Z","timestamp":1777388132000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/cap.2012.0063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1089\/cap.2012.0063"],"URL":"https:\/\/doi.org\/10.1089\/cap.2012.0063","relation":{},"ISSN":["1044-5463","1557-8992"],"issn-type":[{"value":"1044-5463","type":"print"},{"value":"1557-8992","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3]]}}}