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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

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Treatment-Emergent Mania in a Prepubertal Boy.

Dulangi Maneksha Amerasinghe Dahanayake¹, Gampolage Swarna Wijetunge¹

¹Child and Adolescent Mental Health Services, Lady Ridgeway Hospital for Children, Colombo 08, Sri Lanka.

Case Reports in Psychiatry

|June 1, 2018

Summary

Pediatric bipolar disorder diagnosis and treatment are challenging. A prepubertal child developed mania on sertraline, indicating a need for more research on managing this condition in children.

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Area of Science:

Child and Adolescent Psychiatry
Neuroscience
Pediatric Mental Health

Background:

Bipolar disorder in children is increasingly recognized but presents diagnostic and management difficulties.
Developmental variations in children complicate accurate diagnosis and treatment.
Limited evidence exists for effective pharmacological interventions in pediatric populations.

Observation:

A prepubertal child initially presented with symptoms suggestive of a depressive episode.
The child was treated with sertraline, a selective serotonin reuptake inhibitor.
Treatment with sertraline led to the emergence of manic symptoms.

Findings:

Selective serotonin reuptake inhibitors (SSRIs) like sertraline may precipitate mania in vulnerable prepubertal children.
Treatment-emergent mania is a significant concern in the pharmacological management of pediatric mood disorders.
This case underscores the complexity of diagnosing and treating bipolar disorder in prepubertal individuals.

Implications:

Further research is crucial to understand the specific presentations of bipolar disorder in prepubertal children.
Developing evidence-based guidelines for the safe and effective pharmacological management of pediatric bipolar disorder is essential.
Clinicians should exercise caution when prescribing antidepressants to prepubertal children with suspected or diagnosed mood disorders.