en Psychiatry Psychiatry Original Research Original Research <p><strong>Background:</strong> In the treatment of bipolar disorder in youths, often more than one medication should be prescribed. In the current<br> study, we compared the efficacy and tolerability of the combination of lithium and quetiapine with lithium and risperidone in the<br> treatment of manic or mixed episodes in children and adolescents.<br> <strong>Methods:</strong> Thirty patients (aged 10-18 years) who were hospitalized for a manic or mixed episode were recruited from consecutive<br> inpatient admissions to the Child and Adolescent Psychiatric Unit at Razi Psychiatric Hospital (University of Social Welfare and Rehabilitation<br> Sciences, Tehran, Iran) from June 2012 to September. They were randomly treated with lithium (with the usual dose to<br> achieve blood levels 0.8-1) and quetiapine (400-600 mg per day) or risperidone (0.5-6 mg per day). The primary outcome measure<br> with respect to efficacy was the mean decrease in Young Mania Rating Scale (YMRS) score. Side effects were also assessed. The independent<br> t test and two-factor repeated measure analysis of variance (ANOVA) was used for data analysis. P-value of less than 0.05<br> was considered statistically significant.<br> <strong>Results:</strong> The reduction in YMRS scores was similar in both groups. The remission rate (YMRS <12) in the group treated with quetiapine<br> was 80% and with risperidone was 66.6%; the difference was not significant. The most common side effect was sedation in both<br> groups. Extrapyramidal side effects were observed only with risperidone. Both drugs caused increased levels of prolactin.<br> <strong>Conclusion:</strong> Both protocols were effective. Quetiapine in combination with lithium in manic or mixed episodes of bipolar I disorder<br> in children and adolescents was not superior to lithium and risperidone, but was associated with fewer complications.</p> Children, Adolescents, Bipolar Disorder, Quetiapine, Risperidone, Lithium 90 95 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1578-1&slc_lang=en&sid=1 Nastaran Habibi 200319475328460031224 200319475328460031224 No Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Nasrin Dodangi 200319475328460031225 200319475328460031225 Yes Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Ali Nazeri 200319475328460031226 200319475328460031226 No Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran