Medicines for bipolar disorder in adults may not work effectively in bipolar children, and researchers are carefully studying the effects of prescription bipolar medicines in children. Clinical trials with lithium have shown it to be highly effective for both manic and depressive episodes, and several other drugs have been tested for use in children. The Treatment Guidelines for Children and Adolescents with Bipolar Disorder indicate that children need to take these medicines for 4 to 6 weeks before doctors can determine whether the drug is helping.
First-Line Treatments
Lithium and divalproex (Depakote) are the most frequently prescribed single medicines for children with bipolar disorder, according to the Treatment Guidelines for Children and Adolescents with Bipolar Disorder. Lithium is a mood stabilizer and is used for manic, mixed, and bipolar depressive episodes. Divalproex is effective for manic and mixed episodes. Both of these drugs are effective in treating the acute phases of bipolar disorder. Other first-line treatments include carbamazepine (Tegretol), an epilepsy medication; olanzapine (Zyprexa), an antipsychotic medication; quetiapine (Seroquel or Ketipinor), an antipsychotic medication; and risperidone (Risperdal), frequently prescribed for autistic children.
Other Pediatric Bipolar Medications
Aripiprazole (Abilify) is being closely examined by researchers, and ClinicalTrials.gov reports there are currently several trials underway to test its efficacy in children. Oxcarbazepine (Trileptal) is usually combined with a first-line medicine and helps regulate severe mood and behavior disturbances. It is a promising drug for acute mania in adults but clinical data for children has not been provided. Lamotrigine (Lamictal) is an effective mood stabilizer for adults, but the Food and Drug Administration currently bans its use in children under 16 because of increased risk of Stevens-Johnson syndrome, according to the Child and Adolescent Bipolar Disorder Foundation. Gabapentin (Neurontin) is an epilepsy drug which is not recommended as a treatment for childhood bipolar disorder.
Mixed Medication Therapy
When a child is first diagnosed with bipolar disorder, the doctor will usually prescribe one of the first-line treatments as a single medicine, Often, the initial medication will not completely control symptoms of bipolar disorder in children, so the doctor may prescribe other medications to complement the effects. Your doctor can tell you more about combination drug therapies, because there are many considerations before a second or third medicine can be added to your child's bipolar therapy.
Antidepressants
SSRIs (selective serotonin reuptake inhibitors) are antidepressant medication. They are not designed to control the manic phases of childhood bipolar disorder. Buproprion (Wellbutrin) is another depression medication, but the Insight Journal states that its effects in children are not well understood. Antidepressants are sometimes prescribed for acute depression in children, but doctors and parents must create a full clinical history to find out whether a child is suffering from general depression or may have bipolar disorder as well. The Treatment Guidelines for Children and Adolescents with Bipolar Disorder state that as of 2005, there had been no clinical studies of antidepressants as a treatment for the depressive phase of bipolar disorder.
