Pediatric Bipolar Disorder: Evidence‐Based Psychopharmacological Treatments

Abstract

Screening of youth with mood spectrum problems for bipolar disorder should occur in every diagnostic assessment and should be ongoing due to range of mood symptoms and the cyclical and episodic nature of this disorder. Youth with bipolar disorder may manifest symptoms and course that differ from adults. Additionally, co-occuring disorders are common in this population, which can complicate medication selection. Psychopharmacological treatment with the use of specific mood stabilizers and/or atypical antipsychotic medications is warranted depending on symptom presentation; however, monotherapy with mood stabilizers has not demonstrated effectiveness in long-term remission of pediatric bipolar symptoms. Recent research indicates that a combined treatment with two mood stabilizers or a mood stabilizer and an antipsychotic holds promising results for pediatric bipolar I, for youth with acute manic symptoms plus psychosis, and for long-term remission of symptoms.

Ethical issues in psychopharmacology of children and adolescents

“…The database is small for the indication of psychosis, but for the use of risperidone in the indication of behavioural control, it is well established [87][88][89][90][91]. The SGAs are also used in the USA for bipolar disorders in children and adolescents, so that more study results are expected in this regard in the future, and the first substances have already been approved [92][93][94][95]. There is the ethical problem, however, that this diagnosis is the subject of a controversial discussion between the USA and Europe, and therefore the approval in the USA for these substances for the indication 'bipolar' cannot be applied in its entirety to the diagnosis used in Europe; rather, it represents a misconception, if anything [94,96 ,97].…”

Nursing Children and Adolescents With Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management

“…Pediatric bipolar disorder can cause severe disturbances in global functioning (Hamrin & Pachler, 2006). Nurses should therefore make an assessment of the impact of bipolar disorder on the child or adolescent's social functioning, education, and family life.…”

“…Drugs including antipsychotic and mood stabilizers are the mainstay of treatment for bipolar disorder in children and adolescents (Hamrin & Pachler, 2006; National Institute for Health and Clinical Excellence, 2006). Issues of comorbidity not only make the diagnosis of children and adolescents a challenge, but subsequent psychopharmacological treatment may also become problematic.…”

“…Nurses play a crucial role in managing acute episodes, promoting recovery, and helping prevent relapse for children and adolescents with bipolar disorder (Hamrin & Pachler, 2006; Taylor, McDougall, & Wellman, 2006). The neuroanatomy, neurobiology, and psychopharmacological management of pediatric bipolar has been reviewed by Hamrin and Pachler; however, they did not include psychosocial interventions in their review. The purpose of this paper is to provide an emphasis on the role of the nurse in assessment, treatment, and management interventions.…”

Pediatric bipolar disorder: recognition in primary care

“…Medications are an essential first step in treating children with BPD [5**, 34,35]. Guidelines are available for treating children with BP-I [5**].…”