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The treatment of bipolar disorder in children and adolescents 

The treatment of bipolar disorder in children and adolescents
The treatment of bipolar disorder in children and adolescents

Philip Hazell

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date: 07 August 2020

The presentation of bipolar disorder in young people can be different from that of adults; therefore, the approach to treatment differs slightly. Treatment is described for early intervention, acute mania, bipolar depression, relapse prevention, and refractory bipolar disorder. A strong therapeutic alliance with the patient and engagement and involvement of the patient’s family is critical to successful intervention. The evidence informing treatment is limited, but there is emerging research focused on the management of acute mania favouring monotherapy with a second-generation antipsychotic (SGA) over a mood stabilizer. Preliminary data favour a combination of an SGA and antidepressant over monotherapy with an SGA for the treatment of bipolar depression. Guidelines endorse electroconvulsive therapy for refractory mania and bipolar depression but there is no clinical trial evidence to support this practice. The development of algorithms to guide the management of all phases of bipolar disorder is a work in progress.

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