Bipolar Disorder in Children and Teens - Medications

Medications

While medications to treat bipolar disorder have been well studied for use in adults, there are few long-term studies that confirm the effectiveness and safety of mood stabilizers in children and adolescents with bipolar disorder. Be sure to use all medications exactly as your child's doctor has prescribed them. If your child develops intolerable side effects from any medication, call your health professional immediately.

Medication Choices

Medications most often used to treat bipolar disorder in children and adolescents include:

• Mood stabilizers, such as lithium (for example, Eskalith, Lithane, or Lithobid), divalproex (Depakote), carbamazepine (for example, Tegretol), lamotrigine (Lamictal), oxcarbazepine (Trileptal), or valproate (Depacon).
• Antipsychotics, such as olanzapine (Zyprexa), risperidone (Risperdal), or aripiprazole (Abilify). Antipsychotics may be combined with mood stabilizers for more effective control of manic episodes.
• Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac, for example), to control episodes of depression. (While antidepressants can be helpful for some children with bipolar disorder, they can also trigger mania. Doctors usually prescribe antidepressants along with mood stabilizers to help prevent a manic episode, and they need to carefully monitor the child for mood changes.)

Before prescribing medicine to treat bipolar disorder, your doctor will check your child for possible suicidal behavior by asking a few questions. See a list of questions your doctor may ask your child.

What To Think About

Deciding which medications to use to treat bipolar disorder in children and adolescents can be a complicated issue. Be sure to discuss all the options and side effects with your child's doctor. Your child may have to try several medications or combinations of medications before finding what works best. Some medications that seem to work at first may not work in the long term. Carefully monitoring the effects of medications is an ongoing process that is essential in identifying what is working and what may need to be changed.

If the doctor prescribes the mood stabilizer lithium carbonate, your child will need regular blood tests to monitor the amount of lithium in the blood. Too much lithium may lead to serious side effects. Your child will also need regular blood tests to monitor the amount of carbamazepine and divalproex in the blood when using these medications.

When you and your child's doctor are deciding which types of medications to use in the treatment of bipolar disorder, consider:

• The side effects of each medication and how well your child can tolerate them.
• How often your child will need to take the medications.
• Whether your child is being treated for other illnesses or disorders and how those medications will interact with medications for bipolar disorder.
• Whether your child has used any of the medications before and whether they worked.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.