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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.
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.
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