Pediatric Bipolar Disorder: Evidence-Based Psychopharmacological Treatments

The 2007 document reviews psychopharmacological treatments for pediatric bipolar disorder, indicating that monotherapy with mood stabilizers is not effective for long-term remission in children. Studies showed that combined treatments, such as a mood stabilizer with an antipsychotic or two mood stabilizers, are more promising. For example, a study with 30 bipolar adolescents found an 87% response rate with divalproex sodium and adjunctive quetiapine, compared to a 53% response rate with monotherapy. Another study with 37 patients showed 80% and 82% response rates for combinations of divalproex sodium plus risperidone and lithium plus risperidone, respectively. Psychostimulants did not exacerbate manic symptoms in children with comorbid ADHD. However, side effects, particularly weight gain from antipsychotics, were a concern. The document calls for more long-term randomized controlled trials to better assess treatment outcomes for pediatric bipolar disorder.