Mania in childhood. II. Therapeutic trial of lithium carbonate and further description of manic-depressive illness in children.

Six children with childhood mania were identified using established diagnostic criteria. Poor response to tranquilizers led to a therapeutic trial of lithium carbonate. Outpatient administration of lithium carbonate in dosages of 30 to 40 mg/kg/day produced therapeutic blood lithium levels, and improved manic symptoms in all six children. Two of the children had a prolonged remission of symptoms with the lithium treatment. Lithium was discontinued in three patients whose depressive symptoms were uncontrollably worsened. Electroencephalographic epileptiform activity developed in one child receiving lithium carbonate. Using the strict diagnostic criteria for childhood mania, further therapeutic trails including double-blind studies are indicated to establish the proper role of lithium carbonate in the treatment of this disorder.