This research paper presents the medical treatment of bipolar disorder in children and adolescents. Special consideration is given for the concerns of medicating this group related to the drugs used and patient compliance. The review is guided by the following research question: What are the concerns related to prescribing lithium to children and adolescents?
Vastag (2003) reported that prepubescent bipolar disorder is rare and the treatment of children with this disorder is poorly researched. There is limited data regarding the efficacy and safety of using psychotropic medications for treatment in children. Bipolar disorder in children and adolescents tends to be more severe than in adults with ultra-rapid mood cycling several times a day (not found in adults). Extreme irritability is also more common during manic episodes in children (less common in adults). ADHD and bipolar may coexist in children. Prescribing stimulants to children, such as with the use of Ritalin for those that are diagnosed with attention-deficit/hyperactivity disorder (ADHD) is of particular concern since it can trigger or exacerbate manic symptoms.
State, Altshuler, and Frye (2002) reported further on the tendency for a coexistence of mania and ADHD in prepubertal
children. Since bipolar illness in children is considered rare this diagnosis has received little attention. However, in a study of over 900 subjects, it was discovered that .4% of this group had experienced onset of bipolar illness prior to age 10 years. The symptoms of childhood bipolar include temper tantrums, irritability, and rapid cycling of moods. These symptoms are likely to be diagnosed as ADHD. Since Ritalin can exacerbate or cause mania the diagnosis of bipolar is critical for accurate treatment choice. Studied have shown that treatment combinations of stimulants and mood stabilizers may improve symptoms of ADHD without mania exacerbation; lithium and methylphenid...