Table 4.
Initial treatment strategies for bipolar disorder in children and adolescents
| First-line treatment | High second-line treatment | Low second-line treatment | |
|---|---|---|---|
| Children | |||
| Mania | MS plus AAP AAP monotherapy |
MS monotherapy | MS plus other AAP MS plus AAP plus LTG I&O |
| Depression | MS plus AAP/AD MS/AAP monotherapy LTG plus AAP/MS |
MS plus AAP plus AD/LTG MS plus AP plus AD LTG monotherapy AAP plus AD MS plus AP AP/LTG plus AD MS plus AAP plus LTG plus AD I&O |
|
| Adolescents | |||
| Mania | MS plus AAP | AAP/MS monotherapy MS plus other AAP |
MS plus LTG/TAP MS plus AAP plus LTG |
| Depression | AAP monotherapy MS plus AAP/AD AAP plus AD MS monotherapy LTG plus MS/AAP |
LTG monotherapy LTG plus AD AP plus MS MS plus AP plus AD MS plus AAP plus AD/LTG MS plus AAP plus LTG plus AD I&O |
|
Note: Bold: no consensus.
Abbreviations: AP, antipsychotics; AAP, atypical AP; AD, antidepressant; I&O, interview and observation; LTG, lamotrigine; MS, mood stabilizer; TAP, typical AP.