Dr. Diller, as a behavioral pediatrician you certainly prescribe stimulants and other psychiatric medications to children, but at the same time you have spent much of your career speaking and writing about some the potential negative consequences of the excessive use of stimulants. You’ve also studied the history of stimulant use, and have thought about how this can inform our decisions now.

After reading these articles, you should be able to…

We’ve all noticed the trend: children are increasingly being diagnosed with bipolar disorder. This issue is controversial, because psychiatrists are already accused of overmedicating children.

The STEP-BD study, an NIMH-funded study of bipolar disorder, has enrolled its last patient, and we have already begun to see the first results filtering through to the psychiatric journals.

The latest foray into the controversial issue of antidepressant-induced switching appeared in the February issue of The American Journal of Psychiatry (2006;163:232-239). The last time TCPR took up this topic (June 2005), we reviewed a meta-analysis of antidepressant use in bipolar disorder. That paper concluded that SSRIs cause the same rate of manic switching as placebo (Am J Psychiatry 2004;161:1537-1547). The authors of the newly published research would beg to differ.

How common is bipolar II disorder, and are we frequently missing the diagnosis?

What’s in a Name? An awful lot, if you believe the work of Matthew Stanbrook and colleagues.

Dr. Sachs, as the principal investigator of the STEP-BD study, can you walk us through how the study was hatched?

After reading these articles, you should be able to…

While it’s certainly interesting to theorize about neurotransmitters and antidepressants, the recent STAR*D findings bring up a difficult topic: Does mechanism matter?