{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:00:45Z","timestamp":1791669645780,"version":"4.3.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"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":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the efficacy in reduction of depressive symptoms, and safety and tolerability of second-generation antipsychotics (SGAs) to manage pediatric bipolar depression (PBD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review for randomized clinical trials (RCTs) for PBD in MEDLINE, Scopus, and EMBASE. Four (quetiapine: 2, lurasidone: 1, olanzapine-fluoxetine combination [OFC]: 1) out of 569 studies met the criteria for inclusion in meta-analysis. RevMan was used for statistical analysis, and the mean difference (MD) between mean children's depression rating scale-revised (CDRS-R) score was used to measure treatment difference between SGA and placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Lurasidone displayed a significant reduction in depressive symptoms (MD \u22125.70, 95% confidence interval [CI] \u22128.67 to \u22122.73) in PBD, followed by OFC (MD \u22125.00, 95% CI \u22128.64 to \u22121.36) and quetiapine (MD \u22122.30, 95% CI \u22126.80 to 2.20; MD 1.00, 95% CI \u22129.88 to 11.88). The response was significantly higher for lurasidone (59.5% vs. 36.5%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and OFC (78.2% vs. 59.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) compared with placebo. There was no statistically significant MD in treatment and response rates between quetiapine and placebo in all RCTs. The weighted mean CDRS-R total score difference was \u22124.58 (95% CI \u22126.59 to \u22122.56) and overall effect was significant (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). Importantly, the\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      value for heterogeneity was 0.46, which indicated that there was no heterogeneity between outcomes of the studies. The number needed to treat (NNT) for lurasidone was 4.3, followed by OFC (NNT\u2009=\u20095.3) and quetiapine (NNT\u2009=\u200912.5; NNT\u2009=\u200925).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings showed lurasidone and OFC were more efficacious than placebo for acute depressive episodes in PBD. RCTs of treatments for PBD remain scarce pressing the need for more research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2021.0031","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T15:59:49Z","timestamp":1634659189000},"page":"521-530","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Second-Generation Antipsychotics in Management of Acute Pediatric Bipolar Depression: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2895-9155","authenticated-orcid":false,"given":"Rikinkumar S.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, Oklahoma State University, Tulsa, Oklahoma, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9154-6994","authenticated-orcid":false,"given":"Nikhila","family":"Veluri","sequence":"additional","affiliation":[{"name":"American University of Integrative Sciences, St. Michael, Barbados, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenil","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA."},{"name":"Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riddhi","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Machado","sequence":"additional","affiliation":[{"name":"Father Muller Medical College, Mangalore, Karnataka, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasim","family":"Diler","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2009.08101569"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2006.11.006"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2009.11.1\/kchang"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2011.0153"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.SU17023TX1C"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.12740\/PP\/OnlineFirst\/92740"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2009.00728.x"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2017.10.006"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2014.12.012"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(02)00110-7"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2013.0105"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S79586"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-6171.2007.00083.x"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.12.016"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000177048.34506.fc"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.encep.2014.02.006"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.13070984"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2010.0063"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14m09410"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.5.543"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/15622975.2017.1285050"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2020.0018"},{"key":"e_1_3_3_25_1","unstructured":"Smith K : FDA Approves Latuda (Lurasidone) for Treating Bipolar Depression in Kids. Volume 2021 2020 Available from http:\/\/www.pharmacytimes.com\/product-news\/fda-oks-lurasidone-for-use-as-bipolar-medication-in-children."},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S63779"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.18r12180"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10m06290"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.31157\/archneurosciencesmex.v20i2.82"},{"key":"e_1_3_3_30_1","article-title":"Dose-response association of acute-phase quetiapine treatment with risk of new-onset hypothyroidism in schizophrenia patients","volume":"27","author":"Zhao Y","year":"2021","unstructured":"Zhao Y, , Wen SW, , Li M, , Sun Z, , Yuan X, , Retnakaran R, , Zhang R, , Zhai D: Dose-response association of acute-phase quetiapine treatment with risk of new-onset hypothyroidism in schizophrenia patients. Br J Clin Pharmacol, 27, 2021. 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