Principles of managing bipolar disorder in children
Principles of managing bipolar disorder in children are similar to those for adults and young people (see Principles of managing bipolar disorder in adults and young people). Also consider:
- multidisciplinary care should ideally be provided by a specialist service with practitioners experienced in treating bipolar disorder in children, who closely collaborate with the child’s parents or services (eg educational, juvenile, forensic) as appropriate
- careful attention should be given to the impact of bipolar disorder and its treatment on the child’s development, education and social relationships
- there is limited evidence to guide management and considerable disparity in clinical practice
- antipsychotics are preferred to lithium, sodium valproate or carbamazepine; however, children may be at greater risk of antipsychotic adverse effects including extrapyramidal adverse effects, effects due to elevated blood prolactin concentration, and weight gain. The general practitioner may be involved in monitoring for antipsychotic adverse effects; the child’s weight should be measured regularly and they should be encouraged to maintain a healthy diet and exercise1
- there is a weak evidence base and the potential for significant adverse effects with other drugs for bipolar disorder, such as lithium, sodium valproate or carbamazepine. Monitoring for adverse effects of lithium, sodium valproate or carbamazepine is usually undertaken by the treating specialist.
1 For advice on a healthy diet, see Australian Dietary Guidelines. For advice on physical activity, see Australia's Physical Activity and Sedentary Behaviour Guidelines and the Australian 24-Hour Movement Guidelines.Return