Treatment of bipolar disorder in pediatric population

Objectives
This article aims to present current information on the treatment of bipolar disorder (BD) in children and adolescents, including pharmacotherapy and psychosocial interventions.

Literature review
Current guidelines and recent scientific studies on the treatment of BD in children and adolescents were reviewed, with particular attention to the use of antipsychotic medications such as cariprazine, ziprasidone, asenapine, paliperidone and lurasidone.

Conclusions
Treatment of BD in the paediatric population must take into account differences in the clinical presentation of the disorder in this age group, as well as differences in response to therapeutic strategies compared with adults. Many second-generation antipsychotics have been approved by the U.S. Food and Drug Administration for the treatment of manic or mixed episodes in the paediatric population. They are often considered first-line treatments because of their effectiveness; however, metabolic adverse effects may limit their use. Antidepressant monotherapy is not recommended for depressive episodes. Psychosocial interventions also play an important role in the treatment of BD; however, no specific psychotherapeutic approach has yet been firmly established for children and adolescents with this disorder. Further research is therefore required on both pharmacotherapy and psychosocial interventions in order to identify safer, more effective and better-tolerated treatment options for manic and depressive symptoms, while also taking into account the frequent comorbidities observed in this age group.