Old drugs vs. new drugs: Treating bipolar disorder in children and adolescents

This is a literature review of the evidence for pharmacological treatment for bipolar disorder in children and adolescents. The review covers drugs that have controlled studies and is divided into older, classical antimanic drugs and the newer mood-stabliser/antipsychotic drugs. The drugs that have had controlled studies are aripiprazole, lithium, olanzapine, oxcarbazepine, quetiapine, risperidone, topiramate, valproate/divalproex drugs and ziprasidone. Carbamazepine, lamotrigine and nefazodone (which is included for completion) were not found to have any evidence from controlled studies. Of the 9 drugs that have evidence, it was found that the newer second-generation antipsychotics had better evidence for efficacy for management of acute mania in children and adolescents: aripiprazole, risperidone, quetiapine and olanzapine. Classical antimanic agents such as lithium and valproate-based drugs had limited evidence.