Section - CAP Smart Takes

02. Treating Pediatric Bipolar Disorder With Comorbid Conduct Disorder

Published on January 1, 2023 Certification expiration date: January 1, 2029

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Can pediatric bipolar disorder with comorbid conduct disorder be effectively treated with second-generation antipsychotics? Yes, of course.
Treating bipolar disorder with comorbid conduct disorder can interrupt the vicious cycles of both conditions feeding on and exacerbating each other.
Remission of bipolar disorder was found to be associated with the remission of conduct disorder in patients with both disorders.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we examine whether pediatric bipolar disorder can be effectively and safely treated with a comorbid conduct disorder. Wozniak and colleagues analyzed 6 identical open-label trials of risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole in 89 pediatric patients with bipolar disorder from 4–17 years of age with conduct disorder and 76 without conduct disorder. So, what did they find? Pediatric patients with bipolar disorder, with and without conduct disorder, treated with second-generation antipsychotics—risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole—had comparable improvement in mania, irritability, grandiosity, impulsivity, and recklessness.

Moreover, this is potentially a huge deal, as treating bipolar disorder with comorbid conduct disorder can interrupt the vicious cycles of both conditions, feeding on and exacerbating each other, creating a perfect storm. If this is an effective treatment, it could decrease the complications among each other. As you

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03. Barriers to Metabolic Monitoring of SGAs in Youth

Learning Objectives:

After completing this activity, the learner will be able to:

Understand that younger children and adolescents with ADHD are most vulnerable to adverse sleep effects; for instance, insomnia can be associated with stimulant medications, whereas daytime sleepiness can be associated with nonstimulants.
Recognize that second-generation antipsychotics are effective and well tolerated for pediatric bipolar disorder with comorbid conduct disorder.
Identify that adherence to clinical guidelines for metabolic monitoring of SGA is inadequate.
Recognize that alpha-2 agonists improve hyperactivity, impulsivity, and inattention, whereas bupropion may be especially effective for ADHD with comorbid depression and substance use disorder.
Acknowledge that comprehensive behavioral intervention for tics is the first-line intervention for persistent tic disorders.

Original Release Date: January 1, 2023

Review and Re-release Date: January 1, 2026

Expiration Date: January 1, 2029

Expert: David Rosenberg, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.