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Treatments for children

What is childhood bipolar disorder?

Bipolar disorder is a chronic psychiatric illness that can have devastating effects on individuals and their families. It is the sixth leading cause of disability worldwide, with prevalence estimated to be around 1% in the general adult population. The age of onset of bipolar disorder typically occurs during early adulthood, although onset can occur in childhood or adolescence. Bipolar disorder in childhood and adolescence is commonly associated with impairment in multiple domains, including increased risk of psychiatric hospitalisation, antisocial behaviour, addictions, and suicidal behaviour. There is a need to optimise treatments for childhood patients for whom medication use could be long-term, with concerns about potential overuse and side effects in a population who are undergoing relevant biological, psychological, and social maturational changes.

What is the evidence on pharmaceutical treatments for childhood bipolar disorder?

Moderate to high quality evidence suggests a medium-sized improvement in mania symptoms with second-generation antipsychotics aripiprazole, olanzapine, risperidone and ziprasidone compared to placebo. Moderate to low quality evidence suggests a small improvement in mania symptoms with mood stabilisers divalproex, lithium, oxcarbazepine and topiramate compared to placebo.

Moderate quality evidence suggests no differences in improvement in depressive symtoms with quetiapine compared to placebo. Low quality evidence is unable to determine any effects of other pharmaceutical treatments for depressive symptoms

Antipsychotics may cause more weight gain and drowsiness than mood stabilisers, while mood stabilisers may cause more akathisia (inner restlessness).

April 2019

Last updated at: 7:34 am, 9th April 2019
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