Psychopharmacology for Pediatric Bipolar Disorder

Pediatric bipolar disorder (PBD) is bipolar disorder diagnosed before the age of 18. PBD is strongly associated with high rates of morbidity, psychosocial impairment, suicidal behavior, and mortality. Mood stabilizing medications play a key role in the treatment of PBD. Psychotherapy and psychosocial interventions augment pharmacological treatment by improving coping skills and psychosocial functioning. In this chapter, we review mood stabilizing agents used for the treatment of PBD. They include atypical antipsychotics, lithium, and certain antiepileptic medications. Our goal is to assist providers in making evidence-based medication choices by formulating medications’ context, side effects, efficacy, and approaches to judging each medication’s potential risks and benefits. We discuss practical prescribing information including dosing, tapering, approaches to partial and no response to medication, side effects, and polypharmacy management. Treatments of bipolar depression and bipolar mania are discussed separately. Figures and tables summarize medication evidence grades, treatment algorithms, guidelines for clinical dosing regimens, and clinical pearls. This comprehensive chapter offers a valuable evidence-based resource on the pharmacological treatment of PBD for prescribers across multiple disciplines and levels of experience.