Medication treatment of bipolar disorder in developmentally disabled children and adolescents

The authors conducted a literature search using major databases covering the period from 1950 to June 2007 on the somatic treatment of bipolar disorder (BD) in normally developing and developmentally disabled youth. BD is an under-recognized condition in patients with developmental disabilities (DD) that further impairs the functioning of patients who already suffer from severe disability. However, while core symptoms of developmental disability cannot be cured, symptoms of BD in this population do respond to appropriate treatments. Moreover, successful treatment of bipolar spectrum disorder may improve social reciprocity or even cognitive functioning in certain patients. Diagnosis and treatment of BD present specific challenges as manifestation of symptoms may differ from people with normal cognitive functioning as may tolerability and side effect profile of conventional treatments. Systematic review and analysis of the literature allow tentative guidelines for treating BD in this vulnerable population. Clinical trials are clearly needed to further accumulate data for evidence-based treatment.