Antipsychotic treatment for bipolar disorder in the pediatric population

The phenomenology of bipolar disorder in the pediatric population is different from that seen in adults. This can present a major obstacle in the accurate diagnosis of the illness and may also hinder the initiation of appropriate treatment. Historically, the mood stabilizers lithium, divalproex, and carbamazepine have been studied in the pediatric population with varying degrees of methodologic rigor. Recently, a body of literature has grown regarding the use of atypical antipsychotics for the treatment of pediatric bipolar disorder. Atypical antipsychotics have shown promise in the treatment of young people who present with symptoms of mania, but long-term adverse effects such as weight gain and tardive dyskinesia might be a concern with these agents and may be particularly worrisome. Children and adolescents tend to be more susceptible to antipsychotic-related adverse effects than adults; therefore, the risk of adverse effects must be balanced against the potential benefits associated with these agents.