Pharmacotherapeutic strategies for pediatric bipolar disorder

There has been a recent increase in recognition and diagnosis of pediatric bipolar disorder (PBD), along with an increase in prescriptions for psychotropic medications for treating children suffering from this chronic, potentially disabling disorder. Lithium remains the only FDA-approved mood stabilizer for use in children > 12 years of age and along with valproic acid and carbamazepine, forms the triad of traditional mood stabilizers used for initiation of treatment for PBD. There has been a recent surge in the use of atypical antipsychotics in PBD, which may be due to their relative ease of administration and lack of requirement for serum level monitoring. A combination of traditional mood stabilizers along with atypical antipsychotics is commonly used in clinical practice, despite a lack of compelling empirical data. Although there is an urgent need for controlled studies on the available treatment options and strategies in PBD, recent expert consensus guidelines and emerging controlled pharmacotherapy data on PBD will lay the platform for future scientific research in the area.