Psychopharmacologic Treatment of Children and Adolescents with Bipolar Disorder: A Review

Background/Objectives: Pediatric bipolar disorder (BPD) is a serious, chronic psychiatric illness that impacts a substantial number of youth in the United States. Pharmacological treatments that are effective and safe, both acutely and over the long-term are needed. Methods: A literature review pertaining to the pharmacotherapy of pediatric bipolar disorder was conducted on PubMed and Science Direct. This yielded a total of 65 publications that were subsequently examined. Nine of these were review articles. There were also two posters identified that were presented at the following meetings: the American College of Neuropsychopharmacology, Annual Meeting and the American Academy of Child and Adolescent Psychiatry Annual Meeting that were considered salient. Results: Mood stabilizers (such as lithium), anticonvulsants and antipsychotics are the three primary classes of medication that appear to be most often prescribed for monotherapy in the treatment of youth with bipolar disorder. Aripiprazole, olanzapine, quetiapine and risperidone are all FDA approved for the treatment of youth with bipolar I disorder, with acute manic or mixed states. Lithium is also FDA approved for treating youths suffering from an acute manic episode. An olanzapine/fluoxetine combination (OFC) is currently the only medication approved by the FDA for the treatment of the depressed phase of bipolar disorder in youths. Conclusions: A gap exists between the extant, evidence-based data and the necessities of clinical practice when treating youth with bipolar disorders. Consequently, there is need for pharmacotherapy research targeting children and adolescents.