Medications

Medicines for bipolar disorder in adults have been well studied. But not much research has been completed about how well the medicines work and if they are safe for children and teens.

When you and your child's doctor are deciding which types of medicines to use, consider:

• The side effects of each medicine and how well your child can tolerate them.
• How often your child will need to take the medicines.
• Whether your child is being treated for other illnesses or disorders and how those medicines will interact with medicines for bipolar disorder.
• Whether your child has used any of the medicines before and whether they worked.

Before prescribing medicine to treat bipolar disorder, your doctor will ask questions about possible suicidal behavior.

Be sure to use all medicines exactly as your child's doctor has prescribed them. If your child has intolerable side effects from any medicine, call your doctor immediately.

Medication choices

Medicines most often used to treat bipolar disorder in children and teens include:

• Mood stabilizers, such as:
  • Lithium (for example, Eskalith or Lithobid).
  • Divalproex (Depakote).
  • Carbamazepine (for example, Tegretol).
  • Lamotrigine (Lamictal).
  • Valproate (Depacon).
• Antipsychotics, such as:
  • Quetiapine (Seroquel).
  • Risperidone (Risperdal).
  • Aripiprazole (Abilify).
• Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac, for example).

While antidepressants can be helpful for some children with bipolar disorder, they can also trigger mania. Doctors usually prescribe antidepressants along with mood stabilizers or antipsychotics to help prevent a manic episode. And the doctor needs to carefully monitor the child for mood changes. Antipsychotics can be used alone, or they may be combined with mood stabilizers for more effective control of manic episodes.

Side effects

Medicines for bipolar disorder have side effects that need to be managed. Some things you cannot change, such as increased urination (common with lithium). But you can deal with some side effects like weight gain (common with several medicines used to treat bipolar disorder) by increasing exercise and reducing calorie intake.

You can work with your child and his or her doctor to find ways of coping with side effects. If side effects from a medicine are intolerable, the doctor may have to change the dose or the medicine.

FDA Advisory

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide, such as thinking too much about death or suicide. This is especially important at the beginning of treatment or when the doses are changed.