pediatrics
Bipolar Disorder in Children and Adolescents
Treatment
Mania: 2nd-generation antipsychotics, sometimes mood stabilizers Depression: 2nd-generation antipsychotics plus an SSRI, sometimeslithium , 2nd-generation antipsychotics are the first line of treatment ( Treatment references ). Agents include results in decreased suicidality, less depression and better psychosocial function. These findings mimic those found in adults ( Treatment references ). Antidepressants should not be used alone but in combination with the antipsychotics or 2nd-generation antipsychotics (eg,risperidone) are the first-line treatment for pediatric bipolar disorder. Lithiumcan decrease suicidal ideation. 1.Kendall T, Morriss R, Mayo-Wilson E, et al: Assessment and management of bipolar disorder: Summary of updated NICE guidance.BMJ349:g5673, 2014. doi: https://doi.org/10.1136/bmj.g5673 2.Yatham LN, Kennedy SH, Parikh SV, et al: Canadian Network for mood and anxiety treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: Update 2013.Bipolar Disord15(1):1-44, 2013. doi: 10.1111/bdi.12025 3.Walkup JT, Wagner KD, Miller L: Treatment of early-age mania: Outcomes for partial and nonresponders to initial treatment.J Am Acad Child Adolesc Psychiatry54(12):10081019, 2015. 4.Kowatch RA, Suppes T, Carmody TJ, et al: Effect size oflithium, divalproex sodium, andcarbamazepinein children and adolescents with bipolar disorder.J Am Acad Child Adolesc Psychiatry39(6):713-720, 2000. doi: 10.1097/00004583-200006000-00009 5.Hafeman DM, Rooks B, Merranko J, et al:Lithiumversus other mood-stabilizing medications in a longitudinal study of youth diagnosed with bipolar disorder.J Am Acad Child Adolesc Psychiatry59(10):1146-1155, 2020. doi: 10.1016/j.jaac.2019.06.013 6.Biederman J, Mick E, Spencer TJ, et al: Therapeutic dilemmas in the pharmacotherapy of bipolar depression in the young.J Child Adolesc Psychopharmacol10(3):185-192, 2000. doi: 10.1089/10445460050167296 7.Scheffer RE, Tripathi A, Kirkpatrick FG, et al: Guidelines for treatment-resistant mania in children with bipolar disorder.J Psychiatr Pract17(3):186-193, 2011. doi: 10.1097/01.pra.0000398411.59491.8c 8.Baumer FM, Howe M, Gallelli K, et al: A pilot study of antidepressant-induced mania in pediatric bipolar disorder: Characteristics, risk factors, and the serotonin transporter gene.Biol Psychiatry60(9):1005-1012, 2006. doi: 10.1016/j.biopsych.2006.06.010 