Table 5.

Preferred initial treatment strategies and medications for pediatric and geriatric bipolar patients

	First-line strategy	First-line MS	First-line AAP
Mania in elderly	AAP monotherapy	VAL, LIT	ARI, QUE, OLZ
	MS monotherapy
Depression in elderly	AAP monotherapy	LMT, VAL, LIT	ARI*, QUE, OLZ
	MS monotherapy
	MS+AAP
	AAP+LMT
	MS+LMT
Mania in children	MS+AAP	No first-line recommendation	RIS, ARI
	AAP monotherapy
Depression in children	No first-line recommendation	No first-line recommendation	ARI
Mania in adolescents	MS+AAP	VAL, LIT	RIS*, ARI, QUE
	AAP monotherapy
Depression in adolescents	AAP+LMT	VAL	ARI*, RIS, QUE

MS, mood stabilizers; AAP, atypical antipsychotics; VAL, valproate; LIT, lithium; ARI, aripiprazole; QUE, quetiapine; OLZ, olanzapine; LMT, lamotrigine; RIS, risperidone.

^*Treatment of choice.