Bipolar Disorder in Children and Teens: A Parent's Guide (PDF)

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Lithium is a type of medication calleda mood stabilizer. It can help treat andprevent manic symptoms 11 in childrenages 12 and older. 21 In addition, thereis some evidence that lithium mightact as an antidepressant and helpprevent suicidal behavior. 22 However,FDA’s approval of lithium was basedon treatment studies in adults. In fact,some experts say the FDA might notapprove giving lithium to bipolar youthif the agency were to review this treatmenttoday.Risperidone and aripiprazole are atype of medication called an atypical,or second-generation, antipsychotic.These medications are called “atypical”to set them apart from earliertypes of medications, called conventionalor first generation antipsychotics.Short-term treatment with risperidone can help reduce symptoms of mania ormixed mania in children ages 10 and up. Aripiprazole is approved to treat thesesymptoms in children 10–17 years old who have bipolar I. 21Your child’s psychiatrist may recommend other types of medication, which arelisted below. Studies in adults with bipolar disorder show these medications maybe helpful. However, these medications have not been approved by the FDA totreat bipolar disorder in children.Anticonvulsant medications are commonly prescribed to treat seizures, but thesemedications can help stabilize moods too. They may be very helpful for difficultto-treatbipolar episodes. For some children, anticonvulsants may work better thanlithium. Not every child can take lithium. Examples of anticonvulsant medicationsinclude:• Valproic acid or divalproex sodium (Depakote)• Lamotrigine (Lamictal).Lithium PoisoningChildren may be showing early signs oflithium poisoning if they develop the following:• Diarrhea• Drowsiness• Muscle weakness• Lack of coordination• Vomiting.Take your child to the emergency room ifhe or she is taking lithium and has thesesymptoms. You should know that the riskof lithium poisoning goes up when a childbecomes dehydrated. Make sure your childhas enough to drink when he or she has afever or sweats, such as when playing sportsin the hot summer.Bipolar Disorder in Children and Teens: A Parent’s Guide • 9
Should girls take valproic acid?Young girls taking valproic acid should be monitored carefullyby a doctor. Valproic acid may increase levels of testosterone(a male hormone) in teenage girls and lead to polycystic ovarysyndrome (PCOS) in women who begin taking the medication beforeage 20. 23, 24 PCOS is a serious condition that causes a woman’s eggsto develop into cysts, or fluid-filled sacs. The cysts then collect in theovaries instead of being released by monthly periods.If PCOS is linked to treatment with valproic acid, the doctor will takethe person off this medication. Most PCOS symptoms will improve after switching or stoppingtreatment with valproic acid. 25Valproic acid, lamotrigine, and other anticonvulsant medications have an FDAwarning. The warning states that their use may increase the risk of suicidalthoughts and behaviors. People taking anticonvulsant medications for bipolar orother illnesses should be closely monitored for new or worsening symptoms ofdepression, suicidal thoughts or behavior, or any unusual changes in mood orbehavior. People taking these medications should not make any changes withouttalking to their health care professional.Atypical antipsychotic medications are sometimes used to treat symptoms ofbipolar disorder in children. These medications are called “atypical” to set themapart from earlier types of medications, called conventional or first-generationantipsychotics. In addition to risperidone and aripiprazole, atypical antipsychoticmedications include:• Olanzapine (Zyprexa)• Quetiapine (Seroquel)• Ziprasidone (Geodon).Antidepressant medications are sometimes used to treat symptoms of depressionin bipolar disorder. Doctors who prescribe antidepressants for bipolar disorderusually prescribe a mood stabilizer or anticonvulsant medication at the same time.If your child takes only an antidepressant, he or she may be at risk of switchingto mania or hypomania. He or she may also be at risk of developing rapid cyclingsymptoms. 26 Rapid cycling is when someone has four or more episodes of majordepression, mania, hypomania, or mixed symptoms within a year. 2710 • National Institute of Mental Health
Page 2 and 3: ContentsWhat is bipolar disorder? _
Page 4 and 5: What is bipolar disorder?Bipolar di
Page 6 and 7: In addition to mania and depression
Page 8 and 9: How is bipolar disorder detectedin
Page 10 and 11: Anxiety Disorders. Anxiety disorder
Page 14: Some antidepressants that may be pr
Page 17 and 18: • Sleep problems, such as sleeple
Page 19 and 20: the community. Such therapies may t
Page 21: Where can I go for help?If you are
Page 24 and 25: 28. Sachs GS, Nierenberg AA, Calabr
Page 26 and 27: Reprints:This publication is in the

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