Severity of bipolarity in hospitalized manic adolescents with history of stimulant or antidepressant treatment

Background: Childhood bipolarity (BP) and ADHD frequently co-occur, these children often receive stimulants. Method: We retrospectively evaluated 80 adolescents hospitalized with BP, manic or mixed, assessed severity of hospital course, and compared groups according to current/past stimulant or antidepressant treatment. Results: Lifetime ADHD rate was 49%; 35% of patients had exposure to stimulants and 44% to antidepressants. Stimulant-exposed patients were younger than non-exposed (mean±S.D.=13.7±2 vs. 15.1±2 years, Z=−3.1, P=0.002). Only stimulant exposure was associated with worse hospitalization course (MANCOVA, Wilks’ Lambda=0.87, F=3.4; df=70; P=0.02). Conclusion: Stimulant-exposed BP-adolescents may have more severe illness course not fully explained by ADHD comorbidity. Limitations: Retrospective methodology and lack of structured interviewing make it difficult to quantify exposure to stimulants and antidepressants.