Treatment of bipolar disorder in children and adolescents.

OBJECTIVE

To evaluate the current status of research in the treatment of bipolar disorder in children and adolescents.

METHOD

A Medline search was conducted for articles on pharmacological or psychosocial treatment of bipolar disorder in children and adolescents.

RESULTS

There are no controlled studies with adequate sample size of the efficacy of lithium (or any other treatments) in bipolar children and adolescents. Two large open studies suggest that, overall, lithium is beneficial, but there also are reports of lithium resistance in bipolar children and adolescents. Small open studies suggest that mood-congruent delusions and hallucinations may be treated successfully with lithium alone. Data on adjuncts or alternatives to lithium in bipolar children and adolescents are sparse. Several controlled studies have been published on psychosocial treatment of child and adolescent depression, but none on mania.

CONCLUSIONS

Pharmacological and psychosocial treatments of bipolar disorder in children and adolescents are understudied. There is a need for well-designed, controlled studies of lithium and alternative medications as well as adjunctive psychosocial treatments.