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Pediatric bipolar disorder: Overview of choosing treatment

Author
David Axelson, MD
Section Editor
David Brent, MD
Deputy Editor
David Solomon, MD

INTRODUCTION

The mainstay of treatment for bipolar disorder in children and adolescents is pharmacotherapy [1]. In addition, adjunctive psychotherapy is generally regarded as essential [2].

Fewer studies have been conducted in pediatric bipolar patients than adult patients; thus, treatment is often based upon adult studies [3,4]. However, response to specific medications may differ between youth and adults.

Although pharmacotherapy is indicated for nearly all youth with bipolar disorder, approximately one-third of patients do not receive medications [5]. As an example, an eight-year prospective observational study enrolled youth with mania who were treated in the community (n = 115), and found that antimanic medications (antipsychotics, lithium, or anticonvulsants) were never prescribed to 37 percent [6].

In addition, the wrong medication regimen is frequently administered to children and adolescents with bipolar disorder. A retrospective study found that among bipolar patients who were treated for mania with or without mixed features (n = 282), antidepressant monotherapy was prescribed for 24 percent [5].

This topic reviews the choice of treatment for pediatric bipolar disorder. Other aspects of pediatric bipolar disorder are discussed separately, including the general principles of using pharmacotherapy; efficacy, administration, and side effects of second-generation antipsychotics for mania; efficacy and core elements of adjunctive psychotherapy; assessment and diagnosis; and the epidemiology, clinical features, and course of illness:

                            

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Literature review current through: Nov 2016. | This topic last updated: Wed Apr 27 00:00:00 GMT 2016.
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