As with adults, there is no cure for early-onset bipolar disorder. But medication and counseling can stabilize mood swings and help your child live a relatively normal life. Treatment of childhood bipolar disorder often includes a combination of drugs, usually a mood-stabilizer (Lithium, Trileptal and Depakote are examples) and an antipsychotic (such as Abilify, Risperdal, Seroquel or Zyprexa). A mood-stabilizer removes the highs and lows of the mood swings, while the antipsychotic evens out aggressive and compulsive behavior. In the past, children with bipolar disorder were not prescribed Lithium until they were older, but now more doctors are finding that it works well in young children too.
There are drugs that do not fall under either of these classifications that are sometimes used as well. Some children need to try different combinations of these drugs to figure out what will work best for them, with the fewest side-effects. Unfortunately, few of these medications are approved by the Food and Drug Administration for use in children… so side-effects in children can be different than what adults may experience using these drugs.
Under no circumstances let your child’s doctor initially prescribe a stimulant medication (Ritalin, Concerta, etc) or antidepressant (Prozac, Zoloft, etc) to treat bipolar disorder. Studies show that stimulant medications and antidepressants can trigger rapid cycling and mania in bipolar children. If co-morbid ADHD exists after bipolar symptoms are successfully treated, some bipolar children are able to tolerate low doses of stimulant medications.
The Bipolar Child’s Education
Bipolar children can have a lot of problems in school. The trial-and-error process of determining the right medication mix can create even more behavior problems. And anxiety over learning and socialization with other children can trigger mood swings in otherwise stable children. Bipolar disorder is covered under federal laws requiring appropriate education and accomodations for children with behavioral or physical handicaps. So parents of bipolar children should meet with their school’s special education team and develop an IEP, or Individualized Education Plan, to make sure their child has the right resources and support in school.